Patients with B-cell acute lymphoblastic leukemia (ALL), the most common type of ALL, have limited treatment options after the cancer becomes resistant to chemotherapy. Researchers, however, are now finding promise in a new type of immunotherapy: chimeric antigen cancer cells and T-cells receptor-modified (CAR) T-cell therapy. The therapy might be helpful in ALL as well as in CLL.1
In CAR T-cell therapy, doctors genetically modify a patient’s T-cells to express a CAR that is designed to target CD19, a protein expressed on the cell surface of B-cell lymphomas and leukemias. As a result, the reprogrammed T-cells, or CAR T-cells, make protein that find and attach to antigens on cancer cells to help destroy the cancer cells.
In studies to date, CAR T-cell therapy directed against the CD19 antigen on B-cells appears effective in the treatment of relapsed ALL. Two studies have produced favorable results. In one trial 88 percent of participants experience a complete cancer remission. In another, which tested a different form of CD19-directed CAR T-cell therapy, 14 of the first 20 patients treated in the study experienced complete remission of the disease.
1 Davila ML, Riviere I, Wang X, et al. Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia. Science Translational Medicine. 2014;6(224):224ra25. doi: 10.1126/scitranslmed.3008226.