Dr. John Leonard Discusses Chimeric Antigen Receptor (CAR) T-cell Therapy for Patients with Advanced B-Cell Lymphoma

In an article from Healio HemOnc Today, Lymphoma Program Director Dr. John Leonard commented on a study presented at the 2016 ASCO meeting, which reported that for patients with advanced B-cell lymphoma, remission could be induced through a combination of low-dose chemotherapy and genetically modified T-cells. These genetically modified T-cells are known as chimeric antigen receptor (CAR) T-cells. They are modified to specifically target the CD-19 proteins found on the surface of B-cells. On the findings of the study he said,

“These represent additional data that show that this treatment regimen has potential in the treatment of patients with resistant, aggressive lymphoma. As far as follow-up is concerned, we need additional studies with larger groups of patients, with longer follow-up periods, to see if these responses are going to be durable.”

Look to this space for additional information on CAR T-cell therapy at Weill Cornell Medicine.

Acalabrutinib for Patients with Previously Untreated Chronic Lymphocytic Leukemia

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By Richard Furman, M.D.

Acalabrutinib is a second generation Bruton’s tyrosine kinase (BTK) inhibitor that targets the B-cell receptor signaling and is considered a prime target for the treatment of CLL. Acalabrutinib inhibits BTK activity preventing the activation of the B-cell antigen receptor pathway, and leads to CLL cell death. Recently at the 2016 ASCO annual meeting researchers presented preliminary results from an ongoing phase 1-2 study using acalabrutinib to treat patients with previously untreated CLL. Of the 74 patients enrolled in the trial 72 were evaluable for response. Acalabrutinib was well tolerated, with 72 of 74 patients remaining on treatment at time of analysis and evaluable for response. Neither of the two patients discontinued treatment for drug related adverse events.

The most common side effects were headaches, diarrhea, arthralgia, contusion, nausea, and weight increase, all characterized as mild. Treatment related lymphocytosis occurred in 53% of patients and was resolved in 97% of the affected patients at a median of 7 weeks. Patients who took acalabrutinib experienced a 96% overall response rate (PR=86%, PR-L=10%) with the median time to response being 2-8 months. For patients with untreated CLL the initial safety profile and high response rates are promising. Based on these results a phase 3 trial of acalabrutinib versus ibrutinib has commenced to further study the use of acalabrutinib in the treatment of patients with CLL.

Immunotherapy More Effective in Treating Aggressive Lymphoma than Chemotherapy

Dr. Adrienne Phillips
Dr. Adrienne Phillips

According to findings from a recent clinical trial, people with relapsed or refractory adult T-cell leukemia-lymphoma (ATLL) may have a promising new treatment option. This new option is mogamulizumab, an immunotherapy that augments the immune system in its fight against this aggressive form of lymphoma. The lead author of the study is Dr. Adrienne Phillips, an assistant professor of medicine and a member of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine and an oncologist with the Bone Marrow and Stem Cell Transplant Program at NewYork-Presbyterian/Weill Cornell Medical Center.

The findings of a small clinical trial demonstrate that the antibody drug mogamulizumab, known as moga, induces tumor responses in nearly 28 percent of patients with a fast-growing and difficult to treat blood cancer called relapsed or refractory adult T-cell leukemia-lymphoma (ATLL). These response rates appeared better than the standard chemotherapy comparison results in this study. The investigators say moga may represent a breakthrough in treating ATLL, for which there are currently no drugs approved in the United States to specifically treat the disease. Mogalizumab binds to CCR4 proteins on tumor cells, allowing the immune system to better target them.

“In order to treat an aggressive cancer such as ATLL, you have to think outside the box,” said Dr. Adrienne Phillips…”By working with international collaborators to conduct the largest randomized trial ever in relapsed or refractory forms of this devastating cancer, we have been able to demonstrate the benefits of an innovative, immune based treatment approach and have taken a large step forward in efforts to make this treatment option available for ATLL patients here.”

Dr. Phillip’s findings were presented during the annual meeting of the American Society for Clinical Oncology (ASCO) on June 5th in Chicago. You can read more about her finding’s here.