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EBMT 2021 | The future of cellular therapy

Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France, discusses the future of cellular therapies, in particular focusing on recent developments in the field of chimeric antigen receptor T-cell (CAR-T) therapies. Prof. Mohty also highlights other cellular therapies which are showing potential, including chimeric antigen receptor-natural killer cells (CAR-NK), γδ T-cells, mesenchymal cells and other immune effector cells. This interview took place during the 47th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2021.

Transcript (edited for clarity)

Cellular therapy is becoming really a new pillar for the treatment of hematological malignancies. Historically, we had conventional chemotherapy. Now we have more and more targeted therapy, immune therapies, pharmacologic modulation. When it comes to cellular therapy, I think the first generation of cellular therapy is about autologous stem cell transplant or allogenic stem cell transplant. It’s like my Windows DOS 20 or 25 years ago...

Cellular therapy is becoming really a new pillar for the treatment of hematological malignancies. Historically, we had conventional chemotherapy. Now we have more and more targeted therapy, immune therapies, pharmacologic modulation. When it comes to cellular therapy, I think the first generation of cellular therapy is about autologous stem cell transplant or allogenic stem cell transplant. It’s like my Windows DOS 20 or 25 years ago.

But now I think we are able to deliver some targeted cellular therapies. And the best example is the CAR T-cell or the CAR-T cells for instance, which are already approved in acute lymphoblastic leukemia, non-Hodgkin lymphoma, and hopefully soon in multiple myeloma. And when you look to the results in non-Hodgkin lymphoma and in ALL, actually one can easily speculate that these CAR-T cells are allowing for some long-term disease-free survival in one third or even more of the patient. And this is really of great importance in patients who were heavily pretreated, were in relapse/refractory in desperate situation.

But the story of cellular therapy is not only about CAR-T cells because now we do have many other options, the NK CARs that are coming, the gamma-delta, mesenchymal cells are coming back into the scene. Some form of other immune effectors like dendritic cells are being tested. So, my feeling in general is that we are switching progressively into sort of a second, third, fourth generation of cellular therapies, which will become sort of a new pillar, in addition to all the pharmacologic agent. So, the future really looks brilliant when it comes to cellular therapy, especially that this will go beyond the field of hematology into solid tumors, I think in the near future, but also why not in autoimmune diseases. So really a very exciting field.

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