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ASCO 2025 | Developing strategies for managing patients who relapse after CD19 CAR-T & CD20 bispecifics
Manali Kamdar, MD, University of Colorado Cancer Center, Denver, CO, comments on the need to develop novel treatment strategies for patients with relapsed/refractory (R/R) B-cell malignancies who relapse after CD19 CAR T-cell therapy and CD20 bispecific T-cell engagers. These dual-exposed patients represent a significant clinical unmet need, and Dr Kamdar highlights some promising areas of research that aim to improve outcomes for this difficult-to-treat patient population. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
I think the new unmet need in the field for patients with relapsed/refractory B-cell malignancies are patients who have now been exposed and are refractory to CD19 CAR T-cell therapy constructs as well as CD20 bispecific T-cell engagers. I think this is a space that is beginning to grow and grow quite rapidly, wherein we really have to figure out the best strategy moving forward...
I think the new unmet need in the field for patients with relapsed/refractory B-cell malignancies are patients who have now been exposed and are refractory to CD19 CAR T-cell therapy constructs as well as CD20 bispecific T-cell engagers. I think this is a space that is beginning to grow and grow quite rapidly, wherein we really have to figure out the best strategy moving forward.
I think the biggest challenge that exists for these patients is that the majority may not have preserved counts. So to be able to relax some of the requirements on clinical trials would be really incumbent at this point in time so as to allow more patients to get on clinical trials. I think some of the constructs that I have had very decent success with are the bicistronic CAR T-cell therapies. We have our own homegrown CD19/22 bicistronic CAR. There was data that was presented here by Dr Dahiya exploring the Kite CD19/20 CAR T-cell therapy that showed good outcomes with regards to efficacy. So I think with that in mind, I feel exploring more in the space of cellular therapy, maybe designing cellular therapy products that are agnostic of antigen expression would be really important. And I think the field is clearly moving at a breakneck pace right now, hopefully we’ll get some better constructs with durable efficacy remissions for this unmet need, which is the dual-exposed patients after having progressed on CD19 CARs and CD20 T-cell engagers.
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