Penn-developed CAR T therapy shows long-lasting remissions in non-hodgkin lymphoma

February 17, 2021

PHILADELPHIA--A significant number of non-Hodgkin lymphoma (NHL) patients in a Penn Medicine-initiated clinical trial continue to be in remission five years after receiving the chimeric antigen receptor (CAR) T cell therapy Kymriah™, researchers in Penn's Abramson Cancer Center reported today in the . The findings represent the longest follow-up, published data to date for CAR T cell therapies approved by the U.S. Food and Drug Administration for the treatment of relapsed or refractory large B-cell lymphomas.

Among 24 patients with diffuse large B-cell lymphoma (DLBCL), the most common form of NHL, who received the therapy after their cancers had come back following standard treatments, 46 percent achieved complete remission and 31 percent achieved progression-free survival at five years. Among 14 patients with relapsed or refractory follicular lymphoma, the second most common form of the disease, 71 percent achieved complete remission and 43 percent achieved progression-free survival at five years.

"We found that most of the patients who achieve a remission lasting one year remain in remission five years after being infused with CAR T cells. This is really exciting and demonstrates the durability of this approach," said lead author Elise A. Chong, MD, an assistant professor of Medicine in the division of Hematology-Oncology in Penn's Perelman School of Medicine. "Patients who do not respond to chemotherapy have another option that may offer them long-lasting remissions."

Co-authors of this research include senior author Stephen J. Schuster, MD, the Robert and Margarita Louis-Dreyfus Professor in Chronic Lymphocytic Leukemia and Lymphoma Clinical Care and Research in Penn's Perelman School of Medicine and director of the Lymphoma Program at the Abramson Cancer Center, and Marco Ruella, MD,, an assistant professor in Hematology-Oncology at the Perelman School of Medicine and scientific director of the Lymphoma Program.

The team also studied the long-term persistence of CAR T cells, and found that 50 percent of the patients who experienced and remained in remission after the first year did not have detectable levels of the CAR19 transgene after five years, while only one of the 18 patients who had a relapse of lymphoma within one year after infusion had loss of the transgene. The results suggest that loss of CAR T cell presence may not be a frequent mechanism of resistance to the therapy.

The study results are a follow up to a study from the same clinical trial published in NEJM in 2017 by Schuster, among other researchers, that included patient outcomes collected at 28 months. The results of a global CAR T cell therapy trial in lymphoma patients, sponsored by Novartis and led in part by Penn, were also published in NEJM, which led to the FDA approval for Kymriah for the treatment of relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including DLBCL, high grade B-cell lymphoma, and DLBCL arising from follicular lymphoma, in 2018. Kymriah is a registered trademark of Novartis.

Diffuse large B-cell lymphoma comprises approximately 30 percent of all NHLs, and there are an estimated 27,000 newly diagnosed patients with DLBCL in the U.S. each year. About 6,500 of those patients have relapsed or refractory disease after two or more therapies and may be eligible for approved CAR T cell therapies.
-end-
Editor's Note: The University of Pennsylvania has licensed some technologies involved in these studies to Novartis. Some of the scientists involved in these trials are inventors of these technologies. As a result of the licensing relationship with Novartis, the University of Pennsylvania receives significant financial benefit, and some of these inventors have benefitted financially and/or may benefit financially in the future.

University of Pennsylvania School of Medicine

Related Chimeric Antigen Receptor Articles from Brightsurf:

Antigen tests -- are self-collected nasal swabs a reliable option?
Under certain conditions, antigen testing using self-collected swabs from the anterior nose may constitute a reliable alternative to antigen testing using nasopharyngeal swabs collected by health professionals.

A plant immune receptor: It takes four to tango
A collaborative study on a plant intracellular immune receptor from researchers at the Max Planck Institute for Plant Breeding Research (MPIPZ) not only shows how an important resistance protein is activated during pathogen infection but also reveals some common operational principles with immunity proteins from humans.

A semiconductor chip detects antigen concentrations at 1 parts per quadrillion molar mass
A chip, which can sense antigens at one part per quadrillion molar mass, was created.

Why drugs sometimes cause receptor potentiation rather than inhibition
In order to treat certain brain diseases more precisely and with fewer side effects, researchers are focusing on drugs that only inhibit distinct subtypes of the receptors responding to the neurotransmitter glutamate.

Experimental vaccine that boosts antigen production shows promise against COVID-19
A bioengineering technique to boost production of specific proteins could be the basis of an effective vaccine against the novel coronavirus that causes COVID-19, new research suggests.

Oncotarget: Clonality and antigen-specific responses shape prognostic effects
Oncotarget Volume 11, Issue 27 reported that to delineate the complexity of anti-tumor T-cell responses, the author's utilized a computational method for de novo assembly of sequences from CDR3 regions of 369 high-grade serous ovarian cancers from TCGA, and then applied deep TCR-sequencing for analyses of paired tumor and peripheral blood specimens from an independent cohort of 99 ovarian cancer patients.

New antigen test for detecting COVID-19 could help triage patients during the pandemic
A new antigen test for detecting COVID-19 can return results within 15 minutes.

Anti-carcinoembryonic antigen-related cell adhesion molecule antibody for fluorescence visualization
Oncotarget Volume 11, Issue 4: The research team's aim was to investigate mAb 6G5j binding characteristics and to validate fluorescence targeting of colorectal tumors and metastases in patient derived orthotopic xenograft models with fluorescently labeled 6G5j.

Activation of opioid receptor uncovered
Together with colleagues from Shanghai, Brussels, Canada and the USA, researchers from the University of Bonn have uncovered the binding mechanism of an important pain receptor.

Researchers discover a new way in which insulin interacts with its receptor
The biological actions of insulin are mediated by its receptor--the insulin receptor -- which is localized on the cell surface.

Read More: Chimeric Antigen Receptor News and Chimeric Antigen Receptor Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.