EBMT 2022 | State of the art in ALL: tisa-cel & brexu-cel
Sebastian Giebel, MD, PhD, Maria Sklodowska-Curie Institute – Oncology Center, Gliwice, Poland, comments on the use of chimeric antigen receptor T-cell (CAR-T) therapy in patients with acute lymphoblastic leukemia (ALL). Whilst tisagenlecleucel (tisa-cel) is approved in children and young adults with ALL, brexucabtagene autoleucel (brexu-cel) is used to treat adult patients. CAR-Ts are currently given to patients who fail at least two lines of prior therapy or who relapse after allogeneic hematopoietic stem cell transplantation (alloHSCT), and they are more effective in younger patients. Ongoing research investigating strategies to improve the efficacy and reduce the toxicity of CAR-T therapies will undoubtedly lead to the increased use of this cellular therapy in adults with ALL. This interview took place at the 48th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2022, which was held virtually.
Transcript (edited for clarity)
At the moment, we have two CAR-T products that are approved for patients with acute lymphoblastic leukemia. The first, tisa-cel, is approved for children and young adults up to the age of 25 years. The second, brexucabtagene autoleucel, is approved by the FDA so far, also for adult patients with acute lymphoblastic leukemia. In general, CAR-Ts are considered for patients who fail at least two lines of systemic therapy or who relapse after allogeneic hematopoietic cell transplantation, regardless of the number of previous lines of therapy...
At the moment, we have two CAR-T products that are approved for patients with acute lymphoblastic leukemia. The first, tisa-cel, is approved for children and young adults up to the age of 25 years. The second, brexucabtagene autoleucel, is approved by the FDA so far, also for adult patients with acute lymphoblastic leukemia. In general, CAR-Ts are considered for patients who fail at least two lines of systemic therapy or who relapse after allogeneic hematopoietic cell transplantation, regardless of the number of previous lines of therapy. Results are generally better for children and young adults with a chance of being cured in a range of 50 to 60%, while for adults, the probability of long-term leukemia-free survival is lower, between 20 and 30%. But there is a lot of ongoing investigation, a lot of research to improve the efficacy of CAR-T treatment in adult lymphoblastic leukemia, and also to reduce toxicity that these patients may meet after such treatments. So I’m optimistic, and I believe that in a few years, CAR-T will be more widely used also among adults with acute lymphoblastic leukemia.
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Disclosures
Novartis (speaker’s bureau, consultation fees), Gilead (speaker’s bureau, consultation fees), Angelini (speaker’s bureau, consultation fees, research support), Amgen (speaker’s bureau, consultation fees), Pfizer (speaker’s bureau, consultation fees)
