Is CAR T-cell therapy a safe and effective treatment option for R/R T-ALL and lymphoma?

During the 2023 Society of Hematologic Oncology (SOHO) Congress, the ALL Hub spoke to Maksim Mamonkin, Baylor College of Medicine, Houston, US. We asked, Is chimeric antigen receptor (CAR) T-cell therapy a safe and effective treatment option for relapsed/refractory T-cell acute lymphoblastic leukemia (T-ALL) and lymphoma.

Firstly, Mamonkin discusses recent progress made in the development and evaluation of CAR T-cell therapies in T-ALL and lymphoma. He highlights several strategies that have yielded encouraging results, including autologous CD7-directed CAR T-cell therapies utilizing various methods, such as gene editing to prevent the risk of fratricide in China, CRISPR-based editing of anti-CD7 CAR T cells in the UK, and unedited CD7-directed CAR T cells in the US.

He goes on to mention challenges in the field, including preventing the risk of fratricide, reducing ablation of circulating endogenous CAR T cells, T-cell aplasia, and antigen escape. One alternative approach currently being investigated to overcome antigen escape is the use of different antigen targets, such as CD5-directed CAR T cells. Both CD7 and CD5-directed CAR T-cell therapies are paving the way in the treatment of R/R T-ALL.