Dr. Andreadis on Response to CAR T-Cell Therapy

Charalambos (Babis) Andreadis, MD, MSCE, associate professor of clinical medicine, Department of Medicine, University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discusses response to chimeric antigen receptor (CAR) T-cell therapy.

Response to CAR T-cell therapy may not be immediate, explains Andreadis, noting that a delayed partial response does not mean that the therapy failed. Based on the data surrounding axicabtagene ciloleucel (axi-cel; Yescarta) and tisagenlecleucel (Kymriah), physicians know that patients may take a long time to respond to CAR T cells.

Data have shown that patients may take up to 6 months to respond to axi-cel and up to 12 months with tisagenlecleucel. That response is mostly an imaging epiphenomenon rather than a biological delay, says Andreadis. PET scans can be positive for many reasons including inflammation and T-cell infiltration, adds Andreadis. Therefore, it is important to have some signs of clinical progression or some evidence by biopsy that there is actual disease left before therapy is abandoned or changed.