Dr. Shadman on the Potential for CAR T-Cell Therapy in High-Risk CLL

Mazyar Shadman, MD, a physician and associate professor in the Divisions of Medical Oncology and Clinical Research at Seattle Cancer Care Alliance, discusses the potential for CAR T-cell therapy in patients with high-risk chronic lymphocytic leukemia (CLL).

CAR T is currently being examined in several studies being conducted in patients with CLL, such as the TRANSCEND CLL 004 (NCT03331198), according to Shadman. Additionally, 2 ongoing studies have been presented, including 1 with lisocabtagene maraleucel (liso-cel) monotherapy, as well as a study with liso-cel in patients who received ibrutinib (Imbruvica) concurrently.

This treatment approach appears to be effective in patients with high-risk disease, according to Shadman. With this modality, it's possible to achieve high rates of complete remissions, some of which are durable if the patient has no detectable minimal residual disease, Shadman says. Although the follow-up is short, this is still an important treatment for patients with high-risk CLL, Shadman explains. 

Additionally, the combination of ibrutinib and liso-cel appears to be safe, but larger studies are needed to determine whether the CAR T-cell products contributes to the efficacy or toxicity of the regimen, Shadman says. Although this modality is not currently approved by the FDA for use in patients with CLL, when and if it is, it should be viewed as an important part of the treatment paradigm, especially in the high-risk population, Shadman concludes.