Inside the Clinic: JTCC Experts Highlight Next Steps With CAR T-Cell Therapy

Lori A. Leslie, MD, assistant professor, Hackensack Meridian School of Medicine, director, Indolent Lymphoma and Chronic Lymphocytic Leukemia Research Programs, John Theurer Cancer Center, and Andre H. Goy, MD, physician in chief of the Hackensack Meridian Health Oncology Care Transformation Services, chairman and chief physician officer, John Theurer Cancer Center at Hackensack University Medical Center, and Lymphoma Division Chief, John Theurer Cancer Center, discuss next steps with CAR T-cell therapy.

CAR T-cell therapy has had a significant effect on treatment paradigms throughout lymphoma and leukemia, but its development is still in its infancy, Goy explains. Finding ways to make CAR T-cell therapy more effective and induce more durable, minimal residual disease–negative responses is a key research area, Leslie says. Although toxicity management has improved since the initial approvals of these agents, further reducing toxicity so that these therapies can be safely administered in an outpatient setting is also an area of focus. 

In terms of its placement throughout treatment paradigms, CAR T-cell therapy is currently indicated for more heavily pretreated patients. However, it is being moved into earlier lines of treatment throughout B-cell malignancies and is being expanded to other hematologic malignancies and solid tumors, Leslie adds. CAR T-cell therapy is undoubtedly a game-changer in the relapsed/refractory setting and will likely become an up-front consolidation therapy for high-risk patients, such as those with double-hit lymphoma and mantle cell lymphoma, Goy says.

Ultimately, future treatment throughout oncology will likely place a heavy focus on cellular therapy and T-cell engaging therapy, Goy concludes.