Dr Porter on the Efficacy of CAR T-Cell Therapy in Relapsed/Refractory CLL

David L. Porter, MD, director, Cell Therapy and Transplant, Jodi Fisher Horowitz Professor in Leukemia Care Excellence, Penn Medicine, discusses data supporting the use of CAR T-cell therapy alone or in combination regimens for patients with relapsed/refractory chronic lymphocytic leukemia (CLL), as presented at the Vanderbilt Stem Cell Transplant and Cellular Therapy Symposium.

Considerable data have emerged regarding the use of CAR T-cell therapy in the treatment of patients with relapsed/refractory CLL, highlighting the transformative potential of this treatment modality, Porter says. Notably, conventional CLL treatments have elicited suboptimal outcomes in this patient population, underscoring the need for novel therapeutic approaches, Porter emphasizes. Clinical trials with CAR T-cell therapy over the last decade have yielded pivotal findings, including overall response rates (ORRs) and complete response (CR) rates ranging from approximately 30% to 60%, Porter notes. Although CAR T-cell therapy is not universally effective, these products often produce sustained CRs for patients with CLL. This is particularly impressive considering the limited treatment alternatives available for this patient population, Porter explains. The data accrued with CAR T-cell therapy in CLL strongly indicate that many patients achieving a CR with these products may also achieve long-term disease eradication, representing potential cures, according to Porter.

Additional studies in patients with CLL have explored the combination of CAR T-cell therapy and BTK inhibitors, such as ibrutinib (Imbruvica). Data from these trials, including those conducted at Penn Medicine, have shown enhanced ORRs and a substantial likelihood of achieving minimal residual disease negativity following sequential treatment with ibrutinib and CAR T-cell therapy, further reinforcing interest in this combination regimen, Porter says. Although treatment outcomes with CAR T-cell therapy alone in relapsed/refractory CLL are promising, ongoing research suggests that greater efficacy can be achieved with these products through the integration of novel therapeutic modalities, Porter concludes.