CAR-T Therapy Space 2017 Progress Report

 | Nov 24, 2017 01:06AM ET

The immuno-oncology space has been in the limelight in 2017. The CAR-T therapy space in particular, has been grabbing investors, courtesy of two key approvals.

The FDA’s approval of Novartis AG’s (NYSE:NVS) breakthrough gene transfer treatment, Kymriah (tisagenlecleucel) suspension for the treatment of B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory or in second or later relapse in patients up to 25 years of age was a significant boost for this space. Kymriah, formerly CTL019, is the first chimeric antigen receptor T-cell (CAR-T) therapy approved.

A novel immunocellular therapy and one-time treatment, Kymriah uses patient's T cells to fight cancer. Novartis also submitted a supplemental Biologics License Application to the FDA for Kymriah (tisagenlecleucel) suspension for intravenous infusion for the treatment of adult patients with relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) who are ineligible for autologous stem cell transplant (ASCT). Kymriah was given Breakthrough Therapy designation for r/r DLBCL which, if approved, will be the second indication for Kymriah.

While the long-term impact of the treatment is yet to be evaluated, the approval opens up new frontiers for cancer treatment. To start with, CAR-T uses patient’s cells to identify and destroy cancer cells, thereby making it different from other small molecule or biologic therapies. During the treatment, T cells are drawn from a patient's blood. These cells are then reprogramed in the manufacturing facility to create genetically coded cells. This leads to the creation of a chimeric antigen receptor which recognizes and fights cancer cells and other B cells expressing a specific antigen.

Gilead Sciences, Inc. (NASDAQ:GILD) acquired Kite Pharma to foray into this space. The FDA’s approval of Yescarta (axicabtagene ciloleucel), the latter’s CAR-T therapy candidate provided a significant boost. The FDA approved the therapy as a treatment for refractory aggressive non-Hodgkin lymphoma, which includes DLBCL, transformed follicular lymphoma and primary mediastinal B-cell lymphoma. The therapy is also under review in Europe and an approval is expected in 2018. Gilead also acquired therapy candidates in clinical trials in both hematologic cancers and solid tumors, including KITE-585, a CAR-T therapy candidate that targets B-cell maturation antigen expressed in multiple myeloma.