However, according to Dr Bollard, manufacturing processes for the T-cell product have improved, truncated from 6 to 12 weeks in the past to 14 to 21 days today. And, further clinical studies, now under evaluation by the Children’s Oncology Group, will test the therapy in a different EBV-positive patient population: lymphoma patients after solid organ transplant.

At least 1 investigator remains cautious, however, about the prospect of use in the clinical arena any time soon. 


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A tiny percentage of patients get allogeneic stem cell transplants to treat lymphoma, so “there’s a very, very limited patient population that might benefit,” said Henry Fung, MD, vice chair of the department of hematology/oncology at Fox Chase Cancer Center in Philadelphia, Pennsylvania, in an interview with Cancer Therapy Advisor. And, many of these patients have such aggressive disease that they don’t have time to wait for a suitable donor match, he explained.

Dr Fung describes the research as a proof-of-principle study that shows that EBV-specific T-cell infusions after allogeneic transplant may work in a select groups of patients, especially young patients. 

But, CAR-T therapies, where researchers bioengineer T cells to attack cancer, seem more promising, he said, even though the 2 immunotherapy strategies are not in competition.

Several companies, including the United Kingdom-based biotech company, Cell Medica, already have received fast track designation from the US Food and Drug Administration using this approach.The company’s patient-derived T-cell product targets 4 EBV-associated proteins in refractory or relapsed lymphoma, as well as posttransplant lymphoproliferative diseases.

“You don’t need a donor and there’s no more graft-vs-host disease,” from genetically engineered ‘off-the shelf’ products, such as this, Dr Fung said. “It’s easier and also much cheaper.”

References

  1. McLaughlin LP, Rouce R, Gottschalk S, et al. EBV/LMP-specific T cells maintain remissions of T and B cell EBV lymphomas after allogeneic bone marrow transplantation [published online September 27, 2018)Blood. doi: 10.1182/blood-2018-07-863654
  2. American Cancer Society. Viruses that can lead to cancer. https://www.cancer.org/cancer/cancer-causes/infectious-agents/infections-that-can-lead-to-cancer/viruses.html. Updated July 11, 2018. Accessed November 1, 2018.
  3. FDA News. Cell Medica Granted FDA Fast Track Designation for Lymphoma Immunotherapy. https://www.fdanews.com/articles/180701-cell-medica-granted-fda-fast-track-designation-for-lymphoma-immunotherapy. Updated March 2, 2017. Accessed November 1, 2018.