Regina Myers, MD expresses gratitude for the audience's presence and thanks the event organizers for the invitation. They introduce themselves as a pediatric oncologist speaking at an adult conference, focusing on pediatric AAA (acute lymphoblastic leukemia) and 4-1BB CAR T cell therapies. They mention the high complete response (CR) rates of up to 97% achieved with CAR19 (CAR targeting CD19), but also note the significant challenge of disease relapse after CAR19 treatment, especially in pediatric and adult patients. They attribute relapse to two main mechanisms: loss of CAR T cell persistence and antigen modulation. The speaker delves into various novel approaches to address these issues.
One approach involves CAR T cell reinfusions, which have been shown to improve persistence and reduce relapse risk in some patients, particularly those with peripheral B cell recovery. Another strategy is to use humanized CAR T cell constructs, designed to improve persistence and avoid immune rejection through humanization of certain components. The speaker presents preliminary data on a humanized CAR construct showing promising outcomes in pediatric and young adult patients, suggesting that it induces durable remissions.