COMPILED BY JOHN JOSEPH PARKER, CONTRIBUTING EDITOR
ATLANTIC HEALTH SYSTEM IS treating patients in a new Phase 2 clinical trial of CAR T-cell therapy at Morristown Medical Center. A select number of sites across the United States are involved in this study (sponsored by Juno Therapeutics, Inc.), which is done on an outpatient basis.
“A type of immunotherapy for lym¬phoma known as CAR T-cell therapy has generated a great deal of excite¬ment within the medical community because it involves using a patient’s own immune cells to attack their cancer,” explains the study’s principal investigator, Mohamad Cherry, M.D., medical director of hematology for Atlantic Health System Cancer Care.
“Two types of CAR T therapy are FDA-approved (tisagenleleucel, or Kymriah and axicabtagene ciloleucel, or Yescarta) for certain types of advanced or recurrent lymphoma,” says Dr. Cherry, a nationally known expert at treating and researching blood-related cancers such as lym¬phoma, leukemia and myeloma. “Other CAR T-cell therapies for non-Hodgkin’s lymphoma, including the one we are testing, are now in clinical trials.”
Dr. Cherry is triple board-certified in internal medicine, hematology and medical oncology.
“We are excited to achieve this mile¬stone—offering lymphoma patients CAR T therapy at Morristown Medical Center’s new Breakthrough Treatment Center,” adds Dr. Cherry. “So far, patients with aggressive B cell lym¬phomas receiving approved CAR T thera¬pies respond to the treatment almost 80 percent of the time.”
In CAR (chimeric antigen receptor) T-cell therapy, immune cells known as T cells are removed from the patient’s blood and altered in the lab to have specific receptors (chimeric anti¬gen receptors) on their surface. These receptors can attach to proteins on the surface of lymphoma cells. The T cells are then multiplied in the lab and infused back into the patient’s blood, where they seek out the lymphoma cells and launch a precise immune attack against them.
Both the currently approved lym¬phoma CAR T-cell treatment and treat¬ments in clinical trials do not require that the patient be hospitalized while receiving treatment. CAR T-cell therapies are designed for patients whose lym¬phoma has relapsed.
The current clinical trial is an open label (all patients receive the study medication), multicenter, Phase 2 study in an outpatient setting. The purpose of the study is to determine the safety, pharmacokinetics (the way drugs move inside the body), and efficacy of a CAR T therapy in patients who have relapsed from, or whose disease is resistant to (refractory), two lines of immunochemo-therapy for aggressive B-cell non-Hodgkin’s lymphoma. Study participants will be followed for up to two years.
“We have made great progress in treating non-Hodgkin’s lymphoma over the last several years and survival rates have increased, while there are also a number of promising therapies and treatment approaches now in clinical trials,” explains Dr. Cherry. “Among the treatments available to patients are targeted therapy, chemotherapy, radiation therapy, stem cell transplantation, immuno- therapy and, very rarely, surgery.”
Dr. Cherry suggests that “while newer types of therapy have revolutionized cancer treatment, most non-Hodgkin’s lymphoma patients receive chemotherapy, often as a combi¬nation of chemo drugs or in combina¬tion with immunotherapy, targeted therapy or radiation therapy. Some of these combinations are now being further studied in clinical trials to determine the most effective combina¬tions and doses, with the fewest ide effects.”