CAR T-Cell therapy can lead to long-lasting remissions in patients with lymphoma

immune cells attacking cancer cells

Chimeric antigen receptor (CAR) T-cell therapy is a type of immunotherapy, which is a cancer treatment where patients’ immune cells are reprogrammed to fight their disease. The immune system then attacks the cancer cells as shown in this photo.
Photo courtesy of the National Cancer Institute 

Chimeric antigen receptor (CAR) T-cell therapy is an experimental cancer treatment in which patients’ immune cells are reprogrammed to fight their disease. In clinical trials, the treatment has been very effective for some patients with the aggressive blood cancer diffuse large B-cell lymphoma (DLBCL). After the longest follow-up to date of patients who received CAR T-cell therapy, CCR scientists are now reporting that the remissions induced by the treatment can be long lasting.

In a paper published July 14, 2017, in the journal Molecular Therapy, James Kochenderfer, M.D., Investigator in CCR’s Experimental Transplantation and Immunology Branch, Steve Rosenberg, M.D., Ph.D., in CCR’s Surgery Branch, and colleagues report on seven patients with relapsed DLBCL who received CAR T-cell therapy as part of a clinical trial. Five of the patients experienced complete remissions. More than three years following the treatment, four patients remained in remission.

“This raises the possibility that CAR T cells can be curative for diffuse large B cell lymphoma,” Kochenderfer says.

In CAR T-cell therapy, a patient’s T cells are removed from his or her blood and genetically modified in the laboratory to amplify their ability to find and destroy cancer cells. The modified cells are then returned to the patient by infusion.

For the lymphoma treatment in this study, patients’ T cells were enhanced with a receptor that recognizes CD19, a marker on the surface of all B cells. These reprogrammed T cells kill both lymphoma cells and normal B cells, but for most patients, normal B cells return in the months following the treatment.

Kochenderfer and his colleagues report that patients’ remissions have continued years beyond the point when their B cells recovered. “If the normal B cells recover, that’s clear proof that there’s not a functionally effective CAR T cell population in that patient,” Kochenderfer explains. “Despite that, the lymphoma still stays in remission. This suggests that a T-cell response can completely eliminate lymphoma cells fairly soon after the T cells are infused.”

Summary Posted: 08/2017