Chimeric Antigen Receptor (CAR)

CAR treatments and therapies are used to treat malignant lymphoma.  Up to now, this type of treatment has been more effective with Non-Hodgkin’s Lymphoma in the targeting of B-cells, or B-lymphocytes, a type of white blood cell.

CAR treatments have mostly treated the Non-Hodgkin’s Lymphoma type because according to Carlos A. Ramos M.D.,”CAR T-cells are quite effective when targeting CD19 against B-cell malignancies, but targets for other lymphoproliferative disorders have lagged behind”

Hodgkin’s Lymphoma (HL)

  • Hodgkin’s Lymphoma is diagnosed by detecting the presence of a cell called Reed-Sternberg.
  • This form of cancer is less common.
  • This type typically begins in the neck, chest, or armpit lymph nodes.
  • The median age of diagnosis is 39.
  • This is often diagnosed earlier so, typically, it is a treatable cancer.

Non-Hodgkin’s Lymphoma (NHL)

  • This type is the more common type of lymphoma.
  • This usually begins in the lymph nodes anywhere in the body.
  • NHL is usually not diagnosed until it reaches an advanced state.
  • The majority of patients diagnosed with NHL are over the age of 55.

The non-Hodgkin’s Lymphoma types of cancers include aggressive, fast-growing lymphomas such as Diffuse Large B-Cell Lymphoma (DLBCL), Lymphoblastic Lymphoma (LL), and Mantle Cell Lymphoma (MCL).  This category also includes indolent, slow-growing cancers, like Follicular Lymphoma (FL) and Marginal Zone B-Cell Lymphoma (MZBCL).

CAR treatments and therapies reprogram a patient’s immune cells, or T-cells, to recognize and destroy any cancer cells that can be found throughout the body.  

The T-cells are removed from the patient’s body and reprogrammed through laboratory processes to identify the cancer cells.  The reprogrammed T-cells are replicated and then put back into the patient’s body to perform the seek and destroy mission.

Current Approval Of New Treatments

The U.S. Food and Drug Administration currently approved three (CAR) treatments for malignant lymphoma.

  • Yescarta
    • Treats refractory or resistant Large B-Cell Lymphoma (LBCL)
    • Treats Follicular Lymphoma
    • Treats Marginal Zone Lymphoma
    • Treats Aggressive NHL
  • Kymriah
    • Treats B-cell precursor Acute Lymphoblastic Leukemia (ALL), a condition of too many immature white blood cells in the blood and marrow.
    • Treats children and young adults up to the age of 25.
  • Tecartus: Approved in July 2020 for the treatment of advanced Mantle Cell Lymphoma (MCL).

Investigative Treatments

According to Dr. C.H. Weaver M.D.,”Second-generation CAR T-cellular immunotherapy products are being developed to overcome resistance, reduce side effects and simplify treatment”.

CD19 /CD22 Dual‐Targeted CAR‐T Therapy

AUTO3 is a promising CAR T-cell therapy targeting not only the CD19 antigen on the lymphoma cells but the CD22 as well.

Preliminary findings of this technique are suggesting that it is safe and effective for patients who have relapsed or resistant DLBCL.

Allogeneic CAR T Cell Therapy

This type of treatment takes cells from a non-related donor rather than from the patient themselves.

An advantage to this type of lower-cost therapy is to have the cells on-hand, at-the-ready, rather than waiting for the manufacturing of the patient’s own genetically modified cells. 

Off-the-Shelf CAR NK Products — FT596

This possible off-the-shelf product, FT596, is genetically engineered using human induced pluripotent stem cells (iPSC).

The FDA approved the Fate Therapeutics’ Investigational New Drug Application in September 2019 and the first patient was treated with this method in March 2020.

 

Conclusion

Great strides are in progress when treating Non-Hodgkin’s Lymphoma and the goal is to treat, as simply as possible, the most resistant cancer cells with little side effects.

According to the American Cancer Society, “About 81,560 people will be diagnosed with NHL. This includes both adults and children.  And, about 20,720 people will die from this cancer”.

We want to help in this battle with NHL.  Contact us for more information on how we can help with your CAR T-cell treatment needs.