Minnesota Physician August 2018

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3CAR T-cell therapy from cover

complete response. Yescarta yielded an overall response rate of 70 percent in similar patient populations.

CAR T-cell therapy has revolutionized cancer treatment and sets a precedent A legacy of innovation for cell therapies as “living drugs.” Immunotherapy treatments may one day Fifty years ago, a University of Minnesota care team led by Robert Good, supplement or even replace chemotherapy. In the MD, performed the world’s first successful future, CAR T-cell therapies could also eliminate the matched, related donor blood and marrow need for blood and marrow transplants, according transplant. Stem cell transplants have since to Heather Stefanski, MD, PhD, a pediatric blood become a standard of care for the treatment of and marrow transplant physician who helped lead blood cancers. Now, University of Minnesota Immunotherapy treatments may the study that brought Kymriah to market to treat Health physicians, in partnership with researchers one day supplement or even pediatric acute lymphoblastic leukemia. at the Masonic Cancer Center at the University of replace chemotherapy. Expanding alternatives Minnesota, are at the forefront of innovations and In May 2018, University of Minnesota Health breakthroughs in cellular immunotherapeutics. became certified to offer patients Yescarta for the One patient’s journey treatment of refractory or relapsed diffuse large Cancer survivor Colin Cooley was first diagnosed B-cell lymphoma. A few days later, Kymriah also with follicular non-Hodgkin lymphoma. Cooley’s journey began in 2014. received FDA approval for use in treating the same type of cancer. The two Treatment put the cancer into remission initially. Later, Cooley relapsed, and immunotherapy drugs target the same B-cell protein CD19 on B-cells, but his condition morphed into the more aggressive diffuse large B-cell lymphoma. there were some differences in manufacturing and biological activity. For most patients, CAR T-cell therapies bring hope and open a door to the potentially effective treatment after traditional strategies such as chemotherapy, radiation, or blood and marrow transplants failed. In a multicenter clinical trial of more than 100 adults with relapsed or refractory large B-cell lymphoma, the remission rate after treatment with Kymriah was about 60 percent. Roughly 40 percent of patients achieved a

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AUGUST 2018 MINNESOTA PHYSICIAN

He was treated with a standard chemotherapy approach, but it soon became apparent that his lymphoma was not responding. Cooley was told that his disease is hard to cure and he had only several months to live. His oncologist referred him to University of Minnesota Medical Center. Here, after weighing options, the patient was offered a chance to enroll in a CAR19-T cell clinical trial. In late October 2016, Cooley received

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