Jan. 09, 2024
Over recent years, clinical trials have paved the way for FDA approvals of various CAR-T cell therapy products. Since the FDA first approved the use of CAR-T cell therapy in 2017, Mayo Clinic has been optimizing the technology for a broader range of patients and diseases.
Current research focuses on applying these products earlier in treatment plans, expanding the range of treatable conditions and improving methods to mitigate potential side effects.
"One of my biggest motivations is connecting patients with clinical trials," says Saurabh Chhabra, M.D., M.S., a hematologist/oncologist at Mayo Clinic Comprehensive Cancer Center in Arizona. "We offer clinical trials for patients battling the toughest diseases. In many cases, a clinical trial is the most suitable option for a patient."
The landscape of clinical trials for CAR-T cell therapy
CAR-T cell therapy products are currently not indicated as a first line of treatment. Most FDA-approved commercial CAR-T cell products are for use in relapsed and refractory disease for patients with hematologic malignancies. For example, in relapsed/refractory multiple myeloma, CAR-T cell therapy is only approved as a fifth-line treatment. The earliest approved line of therapy is for lymphomas and B-lymphoblastic leukemia, with products approved as a second line of therapy.
Mayo Clinic offers all FDA-approved commercial CAR-T cell therapies. Additionally, Dr. Chhabra and his team have a large portfolio of CAR-T cell therapy clinical trials available to patients. Through this extensive range of clinical trial options, Dr. Chhabra is exploring new indications, novel products and new targets.
"It is a good idea to explore both commercially available and clinical trial options for patients who may be eligible for CAR-T cell therapy," says Dr. Chhabra.
Researchers at Mayo Clinic are evaluating CAR-T cell therapy against the standard of care for relapsed multiple myeloma and diffuse large cell lymphoma, aiming to use it as an earlier line of treatment than the currently approved indication. Trials like these have led to FDA approval of CAR-T cell therapies in second-line treatment of relapsed/refractory diffuse large B-cell lymphoma. Clinical trials also have shown promising results as an earlier line of treatment in patients with relapsed multiple myeloma, challenging the existing treatment paradigm. Mayo Clinic researchers are now extending cellular therapies to solid organ cancers in addition to ongoing work against blood cancers.
With the changing landscape of CAR-T cell therapy, Dr. Chhabra recommends that the following patients be evaluated for participation in clinical trials:
- Patients with non-Hodgkin's lymphoma and B-lymphoblastic leukemia who have progressed after or not responded to first line treatment.
- Patients with multiple myeloma who have progressed after two lines of therapy.
- All patients with cancer who have exhausted established or approved treatment options and are in need of treatment.
Collaborating for improved patient care and increased access to advanced therapies
Mayo Clinic's unique three-site structure provides widespread access to clinical trials, enhancing cancer care and research. "Our three-site system operates as one center, offering patients extensive expertise and collective wisdom from our teams in Arizona and beyond," says Dr. Chhabra. The clinic focuses on improving access to CAR-T cell therapy. The goal is to collaborate with each patient's existing care team to develop personalized treatment plans.
Dr. Chhabra emphasizes the importance of collaboration between academic and community centers for optimal cancer care. "For superior cancer care, academia cannot work in isolation. Joint efforts between academic and community centers are crucial for achieving the best outcomes for patients," he says.
Each Mayo Clinic location is driven by the needs of the communities it serves, ensuring a national impact while addressing regional priorities. This collaborative approach fuels research, granting patients faster access to therapeutic innovations and advancing the field of cancer care and research.
For more information
Refer a patient to Mayo Clinic.