Saturday, May 14, 2022

CAR-T for FL at EHA 2022

I know I don't write as much about Follicular Lymphoma news outside of the United States as I do about stuff in the USA. I know there is great stuff happening around the world. It's easier for me to get USA news, and I'm doing my best to find out about stuff happening elsewhere.

That's probably most clear around this time of year, as ASCO is coming up. (The same thing happens in December when ASH comes around.) Because I'm so focused on ASCO in May and June, I usually miss out on the European Hematology Association (EHA) Congress, which takes place a couple of weeks after ASCO.

As I said, I'm trying to be better about paying attention to other things. So I'm starting to see some announcements about research that will be presented at EHA this year. (Of course, they are from American companies, but that's who sends me press releases.)

One interesting piece of research is from Mustang Bio. At EHA, they will be presenting on their phase 1/2 clinical trial on MB-106, their CAR-T treatment. Unlike the CAR-T treatments currently available for FL, MB-106 targets CD20, the same protein that is targeted by Rituxan and many other FL treatments. The EHA presentation is called "IMMUNOTHERAPY USING A 3RD GENERATION CD20 TARGETED CAR T-CELL (MB-106) FOR TREATMENT OF B-CELL NON-HODGKIN LYMPHOMA (B-NHL) AND CHRONIC LYMPHOCYTIC LEUKEMIA (CLL)." (It's in all CAPS because I had to cut and paste it because I'm too lazy to re-type it.)

It's a small study -- just 12 patients -- and is open to those who have had a different CAR-T (since they target CD19, a different protein.) Initially, 7 patients received the treatment, but it didn't work for any of them, so they made some changes to the process. After that, 11 of the 12 had a response. Follicular Lymphoma patients made up most of the cohort. There were 9 of them, and 8 of the 9 had a response, with 6 of them having a Complete Response. Safety was excellent -- none of the patients had serious Cytokine Release Syndrome and none had ICAN (a type of nerve damage). 

Looking forward to seeing more commentary about this. If these numbers hold up in larger trials, it will be a really nice alternative to other treatments available.

Another announcement I have seen is from Caribou Bioscience. (Mustang and Caribou? I assume your company needs an animal name to present at EHA?) Their presentation is called "FIRST-IN-HUMAN TRIAL OF CB-010, A CRISPR-EDITED ALLOGENEIC ANTI-CD19 CAR -T CELL THERAPY WITH A PD-1 KNOCK OUT, IN PATIENTS WITH RELAPSED OR REFRACTORY B CELL NON-HODGKIN LYMPHOMA (ANTLER STUDY)." This sounds like a fascinating treatment. It uses CRISPR technology. There needs to be a whole separate blog post about CRISPR, but it basically involves identifying which segment of a gene is responsible for a problem, cutting out that segment, and replacing it with a new "normal" segment. Very cutting-edge. It's also fascinating because it's an allogeneic CAR-T treatment. That means it doesn't use a patient's own T cells. It can use someone else's, possibly making it easier to create, and less expensive. 

This is also a phase 1 clinical trial. Only 6 patients, but 5 of 6 had a response (4 Complete and 1 partial). Safety was decent -- one patient had Cytokine Release Syndrome, and 3 had serious side effects (related to blood counts and nerve damage).

Both of these present some real possibilities for alternatives to CAR-T. It's already a very promising treatment, obviously, but that's how things work with cancer treatments. Researchers build on what works and they make it better. These are both phase 1 trials, and a lot can happen n the years before they are approved, but it's all exciting.

I'll keep looking for more interesting EHA abstracts, and I'll be posting some ASCO comments soon, too.

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