2024-02-06 08:38:01
by Health Editorial Staff
With the arrival of innovative therapies developed in recent years, 70% of people with hematological malignancies such as lymphomas, myelomas and leukemias have new hopes of a cure
They are called CAR-T and are an innovative therapy based on the genetic engineering of patients’ white blood cells to make them more effective in recognizing and defeating tumor cells. After giving new hope to thousands of patients in whom other therapeutic options have failed, CAR-Ts are progressively moving towards the first lines of treatment. This is the case of two new experimental protocols: for large B-cell lymphomas, among the most aggressive forms of lymphoma, but also in multiple myeloma in which the first Italian patient is being treated in the Humanitas Cancer Center, which since 2019 has been one of the major Italian centers dedicated to CAR-T with over 100 patients treated.
«This is an important step forward in the search for increasingly effective therapies – states Armando Santoro, director of the Humanitas Cancer Center -. In the case of multiple myeloma, experimental therapy with anti-BMCA CAR-Ts has given encouraging results in studies with very advanced stage patients, which is why we are hopeful about the benefit of their more timely use. In the case of large B-cell lymphoma, the experimental protocol could pave the way for an exclusively immunotherapy therapeutic path, especially for the most at-risk patients. These innovations demonstrate the great value of scientific research: there is no blood tumor that has not seen a substantial improvement from new therapies. Immunotherapy, from CAR-T to monoclonal antibodies up to the latest frontier of bi-specific antibodies, has had a substantial impact.”
The CAR-T protocol for multiple myeloma
Multiple myeloma is a tumor generated by the tumor transformation of cells that derive from B lymphocytes and which have the task of producing antibodies to fight infections. Over the last decade, the survival of patients with multiple myeloma has significantly improved thanks to new therapies, including proteasome inhibitors, monoclonal and bispecific antibodies. Multiple myeloma, however, remains a disease that has no definitive cure. The new CAR-Ts that recognize the BCMA antigen, now being tested for multiple myeloma, have achieved good results in the treatment of the relapsed/refractory form. «The objective of the new study is to understand if we can obtain greater effectiveness by using them in the first lines of treatment – explains Stefania Bramanti, head of the Autologous Transplant, CAR-T and Apheresis Section of Humanitas Cancer Center -. The study, called KarMMa-9, will specifically evaluate the efficacy of anti-BMCA CAR-Ts in patients with a recent diagnosis of multiple myeloma and in partial remission following a bone marrow transplant. This is a significant step, which demonstrates the advancement of research and the possibility for patients with multiple myeloma to have effective long-term clinical benefits.”
The CAR-T protocol in the front line for high-risk lymphoma
Lymphomas are blood tumors that originate from the uncontrolled growth of some cells of the immune system (lymphocytes or their precursors) which usually protect our body from tumors or bacterial and viral infections. «These out-of-control cells accumulate in the lymph nodes or other organs, giving rise to lymphomas, which can be of different types – explains Carlo Stella, head of Lymphomas and Myeloma at the Humanitas Cancer Center -. The treatment of lymphomas is now based on the combination of chemotherapy, radiotherapy, immunotherapy and, if necessary, stem cell transplant: effective, but not for all patients.” «Aggressive large B-cell non-Hodgkin lymphoma can already be treated in the second line with anti-CD19 CAR-Ts, as per AIFA approval – continues Bramanti –. However, an experimental protocol (Zuma 23) is also available at Humanitas which will evaluate the effectiveness of these CAR-Ts directly as a first-line treatment, instead of chemotherapy. If the results confirm it, this approach will allow us to imagine a cure for these lymphomas with immunotherapy alone in the future.”
Bispecific antibodies in the therapy of multiple myeloma and refractory lymphomas
Bispecific antibodies in the therapy of multiple myeloma or refractory lymphomas
Therapeutic innovation in the treatment of refractory lymphoid tumors (lymphomas and multiple myeloma) has been enriched in recent years by a new class of drugs, bispecific antibodies, which activate T lymphocytes against lymphoma or refractory myeloma cells. «The clinical research of the Hematology of Humanitas Cancer Center has contributed in recent years to the development of various bispecific antibodies, some of which are today approved by the European Medicines Agency for use in patients with aggressive large cell lymphoma who have failed at least two lines of chemotherapy – concludes Carlo Stella -. A few months ago we activated a clinical study that evaluates the effectiveness of a bispecific antibody in the initial phase of treatment in patients with aggressive large cell lymphoma.”
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February 6, 2024 (modified February 6, 2024 | 09:37)
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