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Relapse after HSCT 2021 | Management of relapse after CAR-T

Michael Bishop, MD, University of Chicago, Chicago, IL, discusses the different strategies used to manage patients who relapse following chimeric antigen receptor T-cell (CAR-T) therapy. Whilst strategies to treat patients who progress early on CAR-T therapy have been unsuccessful, there are several methods that have been shown to be effective in patients who relapse at later stages. In particular, Prof. Bishop discusses how using a second CAR-T therapy targeting the same or other surface molecules, such as CD22 and CD20, has been successful in the treatment of patients with diffuse large B-cell lymphoma (DLBCL) and B-cell acute lymphoblastic leukemia (B-ALL). In the case that a second CAR-T therapy is not available, it is possible to use checkpoint inhibitors, chemotherapy or radiotherapy. Prof. Bishop explains that a biopsy should be taken at the time of relapse to find expression of specific surface molecules that will allow selection of the most appropriate treatment. This interview took place at the 2021 Relapse After HSCT² Workshop in New York, NY.