2) This program accredited for #physicians #nurses #pharmacists #physicianassociates #nursepractitioners is supported by an independent educational grant from BMS. Statement of accreditation & faculty disclosures at https://t.co/8oShcATovC#FOAMed #MedTwitter #OncTwitter #lymsm
— @onc_ce (@onc_ce) July 5, 2023
4a) So let's back up for a quick review . . . #CAR_T & #CLL mgmt.
— @onc_ce (@onc_ce) July 5, 2023
🔬 CART = Chimeric antigen receptor (CAR) T-cell therapies. #CARs are recombinant receptors for antigens which redirect the specificity & function of T lymphocytes &/or other immune cells in a single molecule. pic.twitter.com/54cdu9JDOE
4c) Instead, while the current management paradigm in #CLL has changed hugely over the last few years, it has been driven by covalent #BTK inhibitors and #BCL2 inhibitor-based treatment, which forms the cornerstone of both front line & relapsed/refractory treatment approaches. pic.twitter.com/o0fUnAx8xV
— @onc_ce (@onc_ce) July 5, 2023
5a) #CART cells have been studied in small studies for some time in #CLL, with some early data demonstrating high responses & some very long-term remissions. First report was in 2011 🔓 https://t.co/fZGWk8xlh8: tx of 2 pts with R/R #CLL . . .
— @onc_ce (@onc_ce) July 5, 2023
5c) These long-persisting #CAR T cells are #CD4+ cells with cytotoxic capabilities, but also an expanded population of gamma delta CAR T cells has been found in one patient concomitant with #CD8+ CAR T cells during the initial response phasehttps://t.co/9MWGwKWYEx
— @onc_ce (@onc_ce) July 5, 2023
6) #CAR_T cells have also been combined w/the #BTK inhibitor #ibrutinib, utilising the latter's ability to potentially enhance T cell function/fitness via inhibition of #ITK & improve the CAR expansion, viability, and, ultimately, efficacy.
— @onc_ce (@onc_ce) July 5, 2023
See 🔓https://t.co/UQURdLCEaV
8) #Lisocabtagene maraleucel (#Liso_cel) is an autologous, #CD19-directed #CAR_T cell product administered at equal target doses of #CD8+ and #CD4+ CAR T cells. pic.twitter.com/bzKuLimZPv
— @onc_ce (@onc_ce) July 5, 2023
10) SOLUTION?#TRANSCEND 004 demonstrated that liso-cel can induce hi levels of MRD-negative remissions (>60%) & deep responses (CR/Cri 18%) in heavily pre-treated #CLL patients w/ median of 5 prior lines of treatment including #BTK & #BCL2 inhibitors.https://t.co/bsHtMI0fXD pic.twitter.com/gQZfofBRSm
— @onc_ce (@onc_ce) July 5, 2023
12) #TRANSCEND 004 showed that the #CAR T cells could be successfully manufactured, that they expanded adequately, and that they persist in the majority of patients with R/R #CLL, with higher expansion associated with deeper responses.
— @onc_ce (@onc_ce) July 5, 2023
13b) In #TRANSCEND_004, although #cytokine release syndrome and neurotoxicity were both noted & these findings require further exploratory analysis to assess the specific patient & disease profile at higher risk, however treatment was deliverable in this high-risk patient group.
— @onc_ce (@onc_ce) July 5, 2023
14) Long term follow up of #TRANSCEND 004 will enable real insights into the long-term toxicity prolife of #CAR T cell therapy in relapsed/refractory #CLL and how durable undetectable MRD-remissions and complete remissions are with this novel cellular therapy.
— @onc_ce (@onc_ce) July 5, 2023
16) There were more #Lisocel data at #ICML23 ➡️deep, durable responses in pts w/ #follicular #lymphoma #FL & those w/ #mantle cell lymphoma #MCL (summaries below from https://t.co/VDy8SiafYi). These data will be featured in #tweetorials to come soon, so FOLLOW @onc_ce NOW! pic.twitter.com/Uc7VYOrlzt
— @onc_ce (@onc_ce) July 5, 2023
17b) It's d, both #CRS and #neurotoxicity. Both were reassuringly low in #TRANSCEND CLL 004.
— @onc_ce (@onc_ce) July 5, 2023
In that study, #liso_cel was associated with a prolonged duration of response in R/R #CLL. It was :
18) For now, 🥳that you just earned 0.5hr 🆓CE/#CME. Just go to https://t.co/SmHScdZU0E and claim your certificate! Tracking rapid advances in the management of #pan_lymphoma is challenging. Let @tobyeyre82 and our other expert faculty help you keep up!
— @onc_ce (@onc_ce) July 5, 2023