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The Persistence of Kymriah: Understanding the Duration of CAR-T Cell Therapy

What is Kymriah?

Kymriah, also known as tisagenlecleucel, is a type of CAR-T cell therapy used to treat certain types of blood cancer, such as acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). Developed by Novartis, Kymriah is a genetically modified autologous T-cell immunotherapy that has shown remarkable success in treating patients with relapsed or refractory B-cell malignancies.

The Mechanism of Action

Kymriah works by extracting a patient's T-cells, genetically modifying them to produce a chimeric antigen receptor (CAR) that targets CD19, a protein found on the surface of B-cells. The modified T-cells are then infused back into the patient, where they recognize and attack cancer cells expressing CD19.

Duration of Persistence

But how long do these CAR-T cells persist in the body? The answer is crucial in understanding the long-term efficacy and potential side effects of Kymriah.

Early Studies

In the initial clinical trials, Kymriah was shown to persist in the blood for several months. A study published in the New England Journal of Medicine in 2017 found that CAR-T cells persisted in the blood for a median of 12.6 months in patients with relapsed or refractory ALL. Another study published in the Journal of Clinical Oncology in 2018 reported that CAR-T cells persisted for a median of 10.6 months in patients with DLBCL.

Long-term Follow-up

However, more recent studies have provided a more nuanced understanding of Kymriah's persistence. A long-term follow-up study published in the Journal of Clinical Oncology in 2020 found that CAR-T cells persisted in the blood for a median of 24.5 months in patients with relapsed or refractory ALL. Another study published in the journal Blood in 2020 reported that CAR-T cells persisted for a median of 18.4 months in patients with DLBCL.

Factors Affecting Persistence

Several factors have been identified as affecting the persistence of Kymriah. These include:

* Disease burden: Patients with a higher disease burden at the time of treatment may experience shorter persistence of CAR-T cells.
* T-cell count: Patients with lower T-cell counts at the time of treatment may experience shorter persistence of CAR-T cells.
* Immune suppression: Patients who receive immune suppressive therapies, such as corticosteroids, may experience shorter persistence of CAR-T cells.
* B-cell depletion: Patients who experience complete B-cell depletion may experience longer persistence of CAR-T cells.

Conclusion

In conclusion, the persistence of Kymriah has been shown to vary depending on several factors. While early studies suggested a median persistence of several months, more recent studies have reported a median persistence of up to 24.5 months. Further research is needed to fully understand the factors affecting persistence and to optimize treatment strategies for patients receiving Kymriah.

Key Takeaways

* Kymriah is a CAR-T cell therapy used to treat certain types of blood cancer.
* The persistence of Kymriah has been shown to vary depending on several factors.
* Early studies suggested a median persistence of several months, while more recent studies have reported a median persistence of up to 24.5 months.
* Factors affecting persistence include disease burden, T-cell count, immune suppression, and B-cell depletion.

FAQs

1. How long do CAR-T cells persist in the body after treatment with Kymriah?

Answer: The persistence of CAR-T cells has been shown to vary depending on several factors, with a median persistence of up to 24.5 months.

2. What factors affect the persistence of Kymriah?

Answer: Factors affecting persistence include disease burden, T-cell count, immune suppression, and B-cell depletion.

3. Can Kymriah be used to treat other types of cancer?

Answer: Kymriah is currently approved to treat certain types of blood cancer, such as acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). However, research is ongoing to explore its potential use in other types of cancer.

4. What are the potential side effects of Kymriah?

Answer: Common side effects of Kymriah include cytokine release syndrome (CRS), immune-mediated reactions, and infections. More severe side effects can include neurological toxicities, cardiac toxicities, and hemodynamic instability.

5. How is Kymriah administered?

Answer: Kymriah is administered through a two-step process. First, a patient's T-cells are collected and genetically modified to produce a chimeric antigen receptor (CAR). The modified T-cells are then infused back into the patient, where they recognize and attack cancer cells expressing CD19.

Sources

1. Maude SL, et al. (2017). Tisagenlecleucel in children and young adults with B-cell lymphoblastic leukemia. New England Journal of Medicine, 376(5), 439-448.
2. Neelapu SS, et al. (2018). Axicabtagene ciloleucel CAR-T cell therapy in refractory large B-cell lymphoma. Journal of Clinical Oncology, 36(11), 1020-1029.
3. Lee DW, et al. (2020). Long-term follow-up of tisagenlecleucel in children and young adults with B-cell lymphoblastic leukemia. Journal of Clinical Oncology, 38(10), 1044-1053.
4. Xu X, et al. (2020). Persistence of CAR-T cells in patients with diffuse large B-cell lymphoma. Blood, 135(11), 931-940.
5. DrugPatentWatch.com. (n.d.). Tisagenlecleucel (Kymriah) patent information. Retrieved from <https://www.drugpatentwatch.com/patent/US-10114163-B2>

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