Srour Discusses Orca-Q in the Haploidentical Stem Cell Transplant Setting

Samer A. Srour, MD, The University of Texas MD Anderson Cancer Center, Houston, Texas, discusses Orca-Q and where research on the next-generation investigational cell therapy fits for patients undergoing haploidentical allogeneic hematopoietic stem cell transplantation.

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0:08 | If you look at the overall picture, patients who are alive and graft-vs-host disease free, doing well, and without complications at 1 year, it's only in the range of 40%-50%. Most of the patients are still either not cured or if they are cured, they are having big problems from the graft-vs-host disease, infections, and other problems. Because of that, we have been trying to improve the outcomes of the haploidentical stem cell transplantation, and here comes Orca-Q.

0:52 | Instead of giving drugs like cyclophosphamide, which again, can help a large proportion of patients but remains unpredictable how these patients and who these patients will survive at 1 year without relapse and without a graft-vs-host disease. It also comes at the expense of many other complications early after transplant, like infections and increased delayed neutropenia, delayed thrombocytopenia, and increased the frequency of transfusions, among others.

1:29 | Orca-Q is a novel way instead of doing that. Instead of what we call in vivo by giving cyclophosphamide and other drugs like cellcept and tacrolimus, [we ask,] can we do that ex vivo? Before we give the graft, which is the donor cells, can we purify those and keep the good cells because they are good for recipients. They can either decrease the graft-vs-host disease, decrease this infection, etc.

2:17 | Orca-Q, is a more purified graft, there's no engineering, so we keep the hematopoietic progenitor cells to reconstitute the port system, and we also keep certain amounts of iNKT cells to decrease the graft-vs-host disease. We also keep other subsets of the cells which were important to fight for infection and fight for the tumor. With Orca-Q, we are trying to eliminate the need for cyclophosphamide, and that's indeed what we did. Also, we eliminated the need of other immunosuppressive agents, like cellcept or others, except single-agent tacrolimus.