|A first-ever T cell therapy trial for relapsed B cell lymphoma
Non-Hodgkin lymphomas arise in lymphatic cells — a type of white blood cell — in the immune system. There are about 30 different types of non-Hodgkin lymphomas; B cell lymphoma is the most common.
When B cell lymphoma returns after treatment, patients have few options. A new, first-of-its kind study may change that.
City of Hope is conducting the first study of an adoptive central memory T cell therapy in patients undergoing autologous transplant for treatment of relapsed B cell lymphoma.
T cells are a family of white blood cells that are critical to immune system function. City of Hope has contributed heavily to research into harnessing T cells against disease, helping to confirm the potential of genetically modified T cells as a treatment for cancer.
“Our use of central memory T cells as part of an autologous transplant is unique to our therapy and sets our approach apart from other T cell treatments in development,” said Stephen J. Forman, M.D., Francis and Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation (HCT) and chair of City of Hope’s Department of Hematology & HCT. “Central memory T cells have the potential to establish a persistent, lifelong immunity to help prevent recurrence of lymphoma after transplant.”
The new clinical trial focuses on the CD19 protein, which is found on B cell lymphoma. Because it is present on the lymphoma cells, the CD19 protein serves as a key target for T cells developed to treat lymphoma.
Adoptive T cell therapies are created from healthy T cells obtained from the patient. They are then genetically modified to recognize a protein or receptor, such as CD19, to target it specifically to cancer cells. The modified T cells are then cultured over a few weeks to increase their numbers to a level that can fight the cancer after reinfusion into the patient.
In October 2011, the phase I clinical trial began enrolling patients with high-risk intermediate grade B cell lymphomas to assess the safety, dosing and outcome of the therapy. Clinical trial participants have their T cells harvested through blood collection, said Leslie Popplewell, M.D., clinical associate professor in City of Hope’s Department of Hematology & HCT and principal investigator for the clinical trial. The team then modifies the T cells to recognize the CD19 protein and grows those cells while the patient undergoes chemotherapy in preparation for a bone marrow transplant.
After the autologous transplant, in which the patient’s own healthy blood stem cells are reinfused, genetically modified T cells also are infused. Physicians hope these cells will become part of an anti-cancer immune system that develops after transplant to help prevent recurrence of the lymphoma and improve the chance for cure.
Forman and Michael C. Jensen, M.D., professor of pediatrics at the University of Washington in Seattle, led the clinical research team that developed the immunotherapy. The research is funded by the Tim Nesvig for Lymphoma Fellowship and Research Fund.