Year: 2020
Type: article
Abstract: treatment of ibrutinib-refractory CLL patients with ibrutinib and CD19 CAR T cells result in comparable response rates.Disappointingly, the complete response rates were not higher than previously reported by others.7 Third, what are possible other strategies to improve CAR T-cell efficacy in CLL?As T-cell function in CLL is not intrinsically imprinted but can be restored following depletion of leukemia cells, 5,6 1 approach might be to use CAR T-cell therapy not as salvage therapy for highly refractory patients but as consolidation treatment following successful tumor debulking.A better alternative therefore may be to use ibrutinib, possibly combined with therapeutic apheresis to remove mobilized tumor cells.Preclinical studies from Fraietta et al demonstrated that the enhanced antitumor efficacy of CLL CD19 CAR T cells was only observed after at least 5 prior cycles on ibrutinib.9 Hence, the combined debulking with ibrutinib with concurrent T-cell function recovery might represent the next iteration in CLL-directed precision targeting.Along the same line, we recently observed normalization of T-cell function and a specific decrease of follicular T-helper cells, regulatory T cells, and PD1 1 CD8 1 cells following 1 year of treatment with a venetoclax containing regimen. 10 Hence, Gauthier and colleagues have here and in their previous study provided support for a synergistic approach of CLL targeting with both CAR-reprogrammed T cells and ibrutinib; the question remains, however, whether the concurrent treatment of patients with both drugs really results in superior responses.Conflict-of-interest disclosure: A.P.K. receives consultancy fees from AbbVie,
Source: Blood
Author: Rachel E. Rau
Institution: Baylor College of Medicine
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3022529774