CAR T Cells Have Reshaped the Hematologic Cancer Landscape

Michael Bishop, MD, a professor of medicine and director of Hematopoietic Stem Cell Transplantation Program at The University of Chicago Medicine, discusses the different settings where chimeric antigen receptor (CAR) T-cell therapy are used.

Bishop thinks CAR T-cell therapy made a significant impact upon patient care. CAR T cells are indicated for 3 main groups of patients. The first is for non-Hodgkin lymphoma and for pediatric and young adult acute lymphoblastic leukemia (ALL), which has FDA-approved agents. More recent approvals have been for patients with mantle cell lymphoma. Physicians are waiting for what they expect to be the first indication for CAR T-cell therapy in multiple myeloma.

Starting with ALL for the pediatric population, CAR T cells have been a game changer, according to Bishop. These young patients have median overall survivals of less than 6 months, but the high response rates with CAR T are enabling them to potentially go on to an allogeneic stem cell transplant and in some cases, be free of disease.

In the non-Hodgkin lymphoma setting, there are now 3 products indicated for advanced B-cell non-Hodgkin lymphoma, which is significant for patients with totally refractory disease. There is this therapeutic option that is potentially curative. Bishop says investigators are seeing patients out to 5 years without any further therapy after receiving CAR T cells.