Authors: Stacy K. Lewis, M.D., medical oncology/hematology, Providence Cancer Institute
Roxanne Payne, MN, AOCNP, stem cell transplant program, Providence Cancer Institute
For decades, people with lymphoma, leukemia and multiple myeloma largely have received traditional cancer treatments, including chemotherapy, radiation and stem cell transplantation. The emergence of CAR T-cell therapy, however, offers a promising treatment option when blood cancer doesn’t respond to these treatments or if the cancer relapses.
Providence Cancer Institute is a leader in CAR T-cell research, including publication of a July 2022 study in Lancet Oncology that revealed a drug called liso-cel to be an effective, safe second-line treatment for large B-cell lymphoma. In the past decade, the institute has been involved in several CAR T-cell therapy trials that have advanced treatment for patients with blood cancer.
There currently are several open clinical trials at Providence Cancer Institute for patients with hematologic cancers.
CAR T-cell background
CAR T-cell therapy, a type of adoptive cell therapy, involves extracting a cancer patient’s white blood cells (T cells) and reprogramming them with an artificial receptor, called a chimeric antigen receptor (CAR). The modified cells are multiplied in the lab and then returned to the patient’s body where they latch on to and kill malignant cells.
In 2014, the Food and Drug Administration declared CAR T-cell therapy a breakthrough cancer therapy. Earle A. Chiles Research Institute, a division of Providence Cancer Institute of Oregon, is a leader in CAR T-cell therapy research in blood cancer and one of the few highly specialized centers in the world offering the treatment in an outpatient setting.
CAR T-cell therapy breakthrough for outpatient care
In 2018, Providence Cancer Institute was the first of 13 centers in the United States to participate in a CAR T-cell therapy clinical trial for patients who had experienced a relapse or hadn’t responded to an initial treatment for aggressive forms of B-cell non-Hodgkin lymphoma. The phase II OUTREACH trial evaluated the safety and efficacy of lisocabtagene maraleucel (liso-cel), a CAR T-cell therapy, in outpatient and inpatient settings. At the time, CAR T-cell therapy had mostly been administered at university medical centers. Liso-cel also is known by the brand name Breyanzi (Juno Therapeutics, Inc.).
The OUTREACH trial was led by John Godwin, M.D., MS, the recently retired medical oncologist and program leader at Providence Hematologic Malignancies Program. The study findings showed no additional safety risks were associated with outpatient versus inpatient infusion of the CAR T-cell therapy, and the results were published in several journals, including HemOnc Today and OncLive.
Phase II trial leads to FDA approval
In another trial offered at Providence Cancer Institute, liso-cel was studied for efficacy and safety in treating patients with relapsed or unresponsive large B-cell lymphoma after initial treatment, and who were not eligible for a haematopoietic stem-cell transplant. Dr. Godwin was lead investigator in this phase II trial, known as PILOT. The study findings revealed liso-cel to be effective and safe as a second-line treatment for large B-cell lymphoma.
As a result of the findings from the PILOT and other trials, the FDA in a June 2022 announcement approved the drug for treatment of large B-cell lymphoma for eligible adult patients.
Leading research and clinical trials in adoptive cell therapies
Under the leadership of Eric Tran, Ph.D., a National Cancer Institute trained expert in T-cell therapy, our research team continues to explore new avenues in adoptive cellular therapy. Currently, we are:
- Collaborating with our molecular genomics team to identify the unique mutations expressed by tumors, as well as the T cells that can recognize those genetic mutations
- Developing programs to generate personalized, potent and precise T-cell therapies in our own labs to target an individual’s unique cancer cells
Our ongoing clinical trials include a range of hematology studies, including a CAR T-cell therapy trial (TRANSCEND FL) to evaluate the efficacy and safety of liso-cel in patients with relapsed or refractory slow-growing B-cell non-Hodgkin lymphoma. This trial currently is recruiting patients.
In addition, there are several trials open for patients with myeloma. Learn more about hematologic clinical trials at Providence Cancer Institute.
For more information or to refer patients to current studies, call our clinical research team at 503-215-2614 or submit a referral form.
Specialized care close to home
Providence Hematologic Malignancies Program provides focused care for people with Hodgkin and non-Hodgkin lymphomas, leukemia, myeloma and other myelodysplastic syndromes at several locations:
- Providence Cancer Institute – Clackamas Clinic
- Providence Cancer Institute – Franz Clinic (Portland - east)
- Providence Cancer Institute – Newberg Clinic
- Providence Cancer Institute – Hood River Clinic
- Providence Oncology and Hematology Care Clinic – Westside (Portland - west)
- Providence Oncology and Hematology Care Clinic – Seaside
Stacy K. Lewis, M.D., is division director of Medical Oncology/Hematology; and medical director of Autologous Stem Cell Transplant, Providence Cancer Institute
Roxanne Payne, MN, AOCN, is director of Autologous Stem Cell Transplant, Cell Therapy Program and Oncology Advance Practice, Providence Cancer Institute
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