CAR-T Meeting 2024 | CAR-T in the field of autoimmune disease
Raffaella Greco, MD, PhD, San Raffaele Hospital, Milan, Italy, discusses the use of CAR T-cell therapy in autoimmune disease, highlighting the potential for improved patient outcomes with this therapeutic approach. CAR T-cell therapy can better penetrate tissues and results in more pronounced B-cell depletion and reconstitution than current treatment options. Although patients receiving the treatment must continue to be monitored for any long-term complications, Dr Greco emphasizes that the current results are promising and that this therapeutic approach may provide an improved quality of life to patients with autoimmune conditions. This interview took place at the EBMT-EHA 6th European CAR T-cell Meeting in Valencia, Spain.
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Transcript (edited for clarity)
I have really a good view regarding the potential role of these innovative cellular therapies and CAR-T in the field of autoimmune disease because, as from what we have already observed in the autoimmune disease field using autologous transplantation and in selected cases also an allo transplant procedure, in cases with severe and refractory disease we are really able to obtain an immune resetting...
I have really a good view regarding the potential role of these innovative cellular therapies and CAR-T in the field of autoimmune disease because, as from what we have already observed in the autoimmune disease field using autologous transplantation and in selected cases also an allo transplant procedure, in cases with severe and refractory disease we are really able to obtain an immune resetting. And as compared to other therapies that the disease specialists have at the moment for autoimmune diseases, like monoclonal antibodies, I think that the CAR-T option is really a good option because it’s able to better penetrate the tissue and as I mentioned, these diseases are strictly connected with organ involvement. And also, we have the possibility through the CAR-T to have a more pronounced B-cell depletion as compared to the drugs they are adopting nowadays.
And [we’re] able to target, for example, if you are going to target CD19, if this is the target of your CAR-T (but we also have experience with other targets, but just mentioning CD19), you are able to target, for example, plasma blasts that are a really key element in the pathogenesis and development of autoimmune disease.
So what we can expect is that with the procedure of CAR-T, and we have seen the first patients treated all over the world with really promising results, we are able to obtain, after an initial B-cell depletion thanks to the CAR-T, a reappearance of B-cells, a sort of, B-cell resetting, going once again from the [naïve] B-cells. And at the same time, it seems from the first experience we have all over the countries that the procedure is safer as compared to the experience we have in other settings, probably because we do not have a tumor burden here, but it’s an autoimmune disease, so it’s a completely different application.
And I think that nowadays, what is really recommended is trying to have all these experiences monitored, trying to have results also in the long-term follow-up of that patient to see not only the disease outcomes or the disease control but also the complications that may arise in the long-term. But for the moment, I think that this is really a good opportunity to study another approach for patients that have diseases that are chronic, that are highly disabling in terms of quality of life, and in the case of a patient that has already received other treatment without success, you are really giving them a sort of new life for the future with new treatments. So, it’s really an interesting area of investigation for CAR-T.
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