CAR T Cell Therapy for ALL
Published: 2017-08-16 |
Author: Paul W. and Holly A. Ewald, PhD |
Source: Cancer Therapy Advisor
A U.S. Food & Administration (FDA) panel recently recommended that approval of CTL019 chimeric antigen receptor (CAR) T cell therapy for acute lymphoblastic leukemia (ALL)----see related article dated July 18, 2017. This first-ever recommendation for a CAR T therapy was based on evidence that the treatment's clinical benefits outweighed considerable safety concerns. The population eligible for this therapy is restricted to children through young adults with relapsed or refractory B cell ALL, among whom the survival rate can be less than 30%.
CAR T cells have engineered receptors comprised of a cell-surface component that binds to a tumor antigen and is attached to one or more internal signal initiators. CTL019 CAR T cells and designated to identify ALL B cells by the CD19 cell surface protein also expressed on normal B cells.
By design, CAR T cells circumvent major histocompatibility complex (MHC) presentation and thus the pathways to this mechanism of immunological activation. The genetically modified receptor aboard these cytotoxic T cells binds directly with a tumor antigen to initiate cell killing. This approach necessitates CAR T cell interaction with a specific surface molecule, which is often be a self-antigen found on normal and cancer cells.