David L. Porter, MD

In a separate interview with The ASCO Post, David L. Porter, MD, Director of Blood and Marrow Transplantation and the Jodi Fisher Horowitz Professor in Leukemia Care Excellence at the University of Pennsylvania, Philadelphia, said: “It is encouraging that many patients with acute lymphoblastic leukemia will have sustained remissions with chimeric antigen receptor (CAR) T-cell therapy, even without a bone marrow transplant. Dr. Park’s data will allow physicians to be able to decide in more appropriate ways which patients may or may not need to undergo bone marrow transplant after CAR T-cell therapy.”

“Other factors not reported may also be important in making these decisions, such as whether or not the CAR T cells persist after infusion. These results also lend strong support to testing CAR T-cell therapy earlier in the course of disease and in patients with low disease burdens, to see if long-term outcomes and safety can be improved,” Dr. Porter noted.

Study Platform

Jonathan S. Serody, MD

Jonathan S. Serody, MD, Thomas Professor of Medicine, Microbiology and Immunology at the University of North Carolina’s Lineberger Comprehensive Cancer Center, Chapel Hill, commented on the platform used in this study—CD19-28z. Dr. Serody noted that University of Pennsylvania investigators have used CD137/4-1BB–based CAR T cells, which appear to persist longer in vivo than those using CD19-28z. “But there are no head-to-head data showing that either platform is better, and there are no data from investigators at the University of Pennsylvania showing that minimal residual disease makes a difference,” he noted.

“This study suggests that if using CD19-28z as a domain, it probably should be a bridge to transplant. However, patients with minimal residual disease may not need transplant. The data are promising that you may not need further therapy [in this subgroup],” Dr. Serody said. ■

Disclosure: Drs. Porter and Serody reported no conflicts of interest.