Dr. Sotomayor on the Durability of CAR T Cells in Hematologic Malignancies

Eduardo Sotomayor, MD, professor of medicine, Department of Hematology and Oncology, and director, GW Cancer Center, discusses the durability of CAR T cells, as well as ways to combat immune escape mechanisms in hematologic malignancies.

CAR T cells can potentially persist for months or years, Sotomayor says. Moreover, the patient’s natural immune response can generate memory cells that attack recurrent cancer cells and allow continued clinical remission.

This is contingent on whether the cancer cells continue to express the molecule targeted by the CAR T cells like CD19 for example, or if they develop a mechanism of escape to avoid targeting and continue proliferation, Sotomayor says.

However, he adds, treatment is evolving to combat these mechanisms of escape by targeting multiple antigens such as CD20 or CD22. Due to tumor heterogeneity, this appears to be a lucrative strategy. Currently, there are ongoing clinical trials exploring this idea.