Autologous T-Cell Therapy Promising in Advanced Sarcoma

CHICAGO — Infusion of autologous HER2-CAR T cells after lymphodepletion is safe and appears to be associated with objective clinical benefit in patients with advanced HER2+ sarcoma, according to the findings of a small phase I study presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting. 

Meenakshi Hegde, MD, of Texas Children’s Cancer Center, and colleagues reported results from 6 patients with refractory/metastatic HER2+ sarcoma (4 osteosarcoma, 1 rhabdomyosarcoma, 1 synovial sarcoma). Patients had a median age of 16 years (range 5 to 55 years).

Patients received up to 3 infusions of 1 × 10⁸ cells/m² CAR T cells after lymphodepletion with either fludarabine or fludarabine and cyclophosphamide. These therapies induced lymphopenia with an absolute lymphocyte count of less than 100/mL at the day of T-cell infusion. Only fludarabine plus cyclophosphamide induced neutropenia (absolute neutrophil count less than 500/mL) for up to 14 days.

Of the 6 patients, 4 experienced grade 1/2 cytokine release syndrome within 24 hours of CAR T cell infusion that resolved completely with supportive care within 3 days of onset, Dr Hegde’s team reported. T cells expanded in 5 patients (median 89-fold), with a median peak expansion on day 7. CAR T cells could be detected by polymerase chain reaction assay in all patients at 6 weeks postinfusion. The patient with rhabdomyosarcoma had a complete response, 2 patients had stable disease, and 3 had progressive disease. Two patients remain alive, with a median overall survival of 14.2 months.

Read more of Oncology Nurse Advisor‘s coverage of the 2017 American Society of Clinical Oncology Annual Meeting by visiting the conference page.

Reference

1. Hedge M, DeRenzo CC, Zhang H, et al. Expansion of HER2-CAR T cells after lymphodepletion and clinical responses in patients with advanced sarcoma. Oral presentation at: 2017 American Society of Clinical Oncology Annual Meeting; June 2-6, 2017; Chicago, IL.