Finn Peterson
Chimeric Antigen Receptor T (CART) cell therapy represents a novel, potent and potentially curative therapy in hematological malignancies. CD19 directed CARTs have resulted in impressive complete response rates of 90% in acute lymphoblastic leukemia and many of these remissions are durable without any further therapies. Impressive response rates were also reported in non-Hodgkin lymphoma and chronic lymphocytic leukemia. CD19 represents a unique target for CART cells; it’s expressed universally on leukemic cells, has limited off tumor expression and B cell aplasia is well tolerated. A vertical advance in the field of CART cell immunotherapy is to extend its application to non B-cell malignancies as well as to solid tumors. BCMA directed CART cells have been used in refractory multiple myeloma with very encouraging results. CD33 and CD123 directed CARTs have shown potent activity in preclinical models of acute myeloid leukemia and are being investigated in early phase clinical trials. Their expression on normal hematopoiesis warrants the use of follow up rescue transplantation. Furthermore, transient approaches and introduction of suicide mechanisms are needed, several of which are being investigated. Finally, different immunotherapeutic combinations are being developed and optimized and it is an exciting approach to enhance the therapeutic index of CART cell therapy.
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