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An expert highlighted unmet needs in treating T-cell acute lymphoblastic leukemia and where research may focus in the future.
Significant advancements in treating B-cell acute lymphoblastic leukemia (ALL) with innovative therapies like CAR-T cell therapy have surfaced in recent years. However, patients with T-cell ALL continue to face significant challenges, highlighting the need for more research, an expert said.
According to the National Cancer Institute, B-cell ALL is an aggressive type of leukemia when too many B-cell lymphoblasts, or immature white blood cells, are found in the blood and bone marrow. Of note, it is the most common type of ALL. In contrast, T-cell ALL is an aggressive leukemia type when too many T-cell lymphoblasts, or immature white blood cells, are found in blood and bone marrow.
Bispecifics: a type of antibody that binds to two different antigens simultaneously.
CAR-T cell therapy: treatment when a patient’s T cells, a type of immune system cell, are altered in a lab so they can attack cancer cells.
CD7-directed CAR-T cell therapy: T cells that are altered to specifically target the CD7 protein.
Tyrosine kinase inhibitor: a substance that blocks tyrosine kinases, which are a part of many cell functions including cell growth, signaling and division.
At the 42nd Annual Chemotherapy Foundation Symposium, CURE® spoke with Dr. Hannah Levavi to learn more about the unmet needs of patients with T-cell ALL experience and where the potential may lie for the treatment of the disease.
Levavi is an assistant professor of medicine, hematology and medical oncology at The Tisch Cancer Institute at Mount Sinai Hospital in New York.
Transcript:
In my mind, the biggest unmet need is in T-cell ALL. Unfortunately, things like bispecifics are much more complicated when you're trying to direct T cells toward other T cells, and the same exists with CAR-T [cell] therapy.
I don't go through CAR-T in any depth at all in my talk, just because of the scope of the talk, but CAR-T cells have really revolutionized the treatment of B-cell ALL. And we haven't achieved those same responses in T-cell ALL. And we don't really have great immunotherapy options in T-cell ALL.
So for patients who relapse with T-cell ALL, we're very limited. There are some CD7-directed CAR-T trials in T-cell ALL that I'm looking forward to hearing about. There are also some [Venclexta (venetoclax)] combinations that are agnostic to phenotypes, so they can be used in both B-cell ALL and T-cell ALL, and then some other creative combinations using things like TKIs (tyrosine kinase inhibitors) in T-cell ALL, which I'm hopeful will get more data and have some more options for those patients.
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