- Dr. James Kochenderfer, a top scientist at the National Cancer Institute (NCI), thinks that the main focus of CAR-T going forward will be autologous T-cells, according to a report from FierceBiotech.
- A recent abstract published in the Journal of Clinical Oncology by Kochenderfer and his colleagues caused a stir this week thanks to differing interpretations of its results' implications for the CAR-T race. In the abstract, Kochenderfer and his colleagues discuss the results of allogeneic hematopoietic stem-cell transplantation (alloHSCT) in patients with cancer followed by HLA-matched allogeneic CAR-T cell infusion.
- The results of their study showed remission in eight of 20 treated patients, leading some to interpret the study as an implicit vindication of the "off-the-shelf" & "universal" approach used by companies like the French biotech Cellectis.
- Some investors also interpreted the results as a warning sign for companies such as Kite and Juno, which have chosen the "autologous" approach to CAR-T in which a patient's own cells are extracted, re-engineered to attack cancer, multiplied, and infused back into the patient.
Here's the background: The survival rate after allogeneic hematopoietic stem-cell transplantation is often compromised by graft-versus-host disease. Kochenderfer and his team used allogeneic T cells genetically engineered to express a chimeric antigen receptor (CAR) targeting the B-cell antigen CD19.
The positive results (remission in 8 of 20 patients) elicited questions about the use of autologous cells versus allogeneic cells. Kochenderfer emphasized that his team used HLA-matched allogeneic cells rather than unmatched cells in an email to FierceBiotech. That means that the interpretation that some had, that the "universal" and unmatched approach using allogeneic cells is the way to go in CAR-T, was not the actual implication of the study.
"I think the main focus of the CAR field will be autologous cells in the future because in my opinion autologous T cells will be the optimal cells to use with the best chance of undergoing extensive in vivo proliferation and the best chance of persisting long enough to eradicate malignancy," clarified Kochenerfer.