Scientists hail autoimmune disease therapy breakthrough - implications for CLL patients?

[bennevisplace]

Yesterday it was reported that five young patients, who had suffered with systemic lupus erythematosus, are in remission after CAR-T-cell therapy, raising hopes that similar success might be achieved in other autoimmune diseases such as rheumatoid arthritis and multiple sclerosis theguardian.com/science/202...

The cases are written up in Nature Medicine nature.com/articles/s41591-...

According to the study, the therapy in effect wiped out the patients’ aberrant B cells and dramatically improved their condition. The disease affected multiple organs in all five patients, but after the therapy severe symptoms including arthritis, fatigue, fibrosis of the heart valves, and lung inflammation all cleared up. Blood tests on the patients showed that their B cells recovered about four months after the treatment, but they no longer produced aberrant antibodies and the patients remained disease-free.

Writing in the journal, the authors speculate that the therapy led to a “rebooting of the immune system”. “We are very excited about these results,” said Prof Georg Schett, a rheumatologist who led the work at Friedrich-Alexander University in Erlangen-Nuremberg. “Several other autoimmune diseases which are dependent on B cells and show autoantibodies may respond to this treatment. These include rheumatoid arthritis, myositis and systemic sclerosis. But also diseases like multiple sclerosis may be very responsive to CAR T-cell treatment.”

CAR-T-therapy, first used in 2015 to treat an infant with acute lymphoblastic leukaemia, has since been used with some success in other forms of leukaemia including CLL.

There are a lot of "ifs" in this, but the prospect of broader therapeutic application could attract research funds to the technology of CAR-T-cell therapy, which should drive up its efficacy-safety profile and drive down costs, perhaps making CAR-T a viable salvage therapy for a greater number of CLL patients.

CAR-T technology is already making strides biopharma-reporter.com/Arti...

[lankisterguy Volunteer]

Hi bennevisplace,

-

We all are hopeful that CAR-T therapy can be refined to be successful treating CLL, however the results so far are mixed. There have been much better results in other NHLs and Acute Leukemias.

-

Here are some links to the history and concerns:

aacr.org/blog/2020/08/31/an...

allogene.com/car-t-history/

-

I recall that Dr. Carl June had 3 CLL patients in 2013 that had excellent results and one of those is still in remission today. But later trials with CLL were inconsistent, and some theories suggest that CLL has "exhausted" our T-cells as the cause.

-

Len

[Sushibruno in reply to lankisterguy]

😒😒

[bennevisplace in reply to lankisterguy]

A couple of encouraging articles:

Phase 1/2 clinical trial of MB-106, a CD20-targeted, autologous CAR T cell therapy for patients with relapsed or refractory B-cell non-Hodgkin lymphomas (“B-NHLs”) and chronic lymphocytic leukemia (“CLL”) ir.mustangbio.com/news-even... - impressive interim results

A genome-scale screen for synthetic drivers of T cell proliferation (abstract) pubmed.ncbi.nlm.nih.gov/352... - might it be possible to engineer T cells to overcome TME-induced dysfunction?

[Sushibruno]

wow that's really interesting. Ive had lupus for over 35 years. When i told dr. Lamanna that it really never affected me (except for rashes on my arms and ears) she told me don't bother going to the rheumatologist anymore. To add, I haven't gotten the rash in Years. I always suspected my cll diagnosis was because of lupus. But of course there's no way of proving that.

[SofiaDeo in reply to Sushibruno]

Hmmm, not so much the Lupus caused the CLL IMO, as the Lupus is evidence that your immune system was a bit wonky earlier than you thought.

[Sushibruno in reply to SofiaDeo]

makes sense Sofia🙂.

[Buckeye64 in reply to Sushibruno]

I have two cousins that have lupus. I have never read anything that suggested there could be any correlation between cll and lupus, but many of the symptoms are the same. Interesting.

[LeoPa]

CAR T the new aspirin 🙂

[Sushibruno in reply to LeoPa]

I wish it was as easy as just taking an aspirin Leo. But i know what u mean.

[bennevisplace]

It should be interesting to see what comes out of this!

car-tcr-summit.com/program/...

[bennevisplace]

insideprecisionmedicine.com...