Noelle V. Frey, MD, MSCE, Constance and Sankey Williams Associate Professor, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, discusses the results of a study evaluating the utility of co-administered CART22-65s and huCART19 in relapsed/refractory acute lymphoblastic leukemia (ALL) that were presented at the 2021 ASH Annual Meeting & Exposition.

Regarding safety, the results of the phase 1 study showed that 2 of the 13 patients infused with CART22-65s and huCART19 developed toxicity before the 28-day assessment. Of these patients, 1 died from therapy-related complications, and 1 developed rapidly progressive disease, Frey said. However, the 11 patients who were evaluable at the 1-month time point allachieved complete remissions that were minimal residual disease negative, Frey explains.

Overall, the co-administered products were well tolerated; cytokine release syndrome (CRS) and neurotoxicity were observed but manageable, Frey said. Hemophagocytic lymphohistiocytosis-like syndrome (HLH) was a unique toxicity attributed to CART22-65s. HLH is clinically distinct from traditional CRS and has been noted in CART22-65s products before, Frey adds. The toxicity was mitigated in the patient who developed HLH, and they were able to continue with a sustained remission, Frey concludes.

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Noelle V. Frey, MD, MSCE, discusses the results of a study evaluating the utility of co-administered CART22-65s and huCART19 in relapsed/refractory acute lymphoblastic leukemia that were presented at the 2021 ASH Annual Meeting & Exposition. 


Dr. Frey on the Utility of CART22-65s with huCART19 in Relapsed/Refractory ALL 

Noelle Frey, MD, MSCE, associate professor of medicine, Perelman School of Medicine, University of Pennsylvania, discusses measuring minimal residual disease (MRD) throughout treatment for patients with acute lymphocytic leukemia (ALL).

Measuring MRD throughout treatment should be a standard of care for all patients with ALL because MRD helps the patient and physician understand the disease prognosis, explains Frey. When patients are MRD positive, even when they are in complete remission, their chances of relapsing are very high, says Frey.

Newer agents that work very differently than chemotherapy are important tools for patients who are MRD positive and resistant to chemotherapy, according to Frey. Blinatumomab (Blincyto), which was 

 to treat patients with ALL who are MRD positive, Frey concludes.

Noelle Frey, MD, MSCE, discusses measuring minimal residual disease throughout treatment for patients with acute lymphocytic leukemia.

Dr. Frey on Measuring MRD Throughout Treatment for ALL

Noelle Frey, MD, MSCE, associate professor of medicine, Perelman School of Medicine, University of Pennsylvania, discusses the use of CAR T-cell therapy in acute lymphocytic leukemia (ALL).

CAR T-cell therapy is a very exciting area of research in ALL, says Frey. Although this approach has not been used in the upfront setting for these patients, it's an intriguing area to pursue—especially in high-risk patients who are unlikely to benefit from traditional chemotherapy approaches.

CAR T-cell therapy may also be a reasonable option for patients with minimal residual disease-positive tumors who have a later relapse, in the context of a clinical trial, adds Frey. These studies would compare the efficacy of CAR T-cell therapy with agents such as blinatumomab (Blincyto) or inotuzumab ozogamicin (Besponsa), she concludes.

Noelle Frey, MD, MSCE, discusses the use of CAR T-cell therapy in acute lymphocytic leukemia.

Noelle Frey, MD, MSCE

Articles

Dr. Frey on the Utility of CART22-65s with huCART19 in Relapsed/Refractory ALL

Dr. Frey on Measuring MRD Throughout Treatment for ALL

Dr. Frey on CAR T-Cell Therapy in High-Risk ALL