Follow-up of patients undergoing CAR T cell therapy – new tools for immune monitoring

Chimeric antigen receptor (CAR) T cell therapy has emerged as an important therapeutic option for hematological malignancies.

A sensitive follow-up of patients undergoing CD19-targeted CAR T cell therapy is important to analyze,  e.g., the in vivo expansion and persistence of these cells in the context of the clinical response of the patient. Furthermore, down-stream analysis of CAR T cells isolated from the patients’ blood could help identify factors that distinguish responders from non-responders. 

In this webinar Prof. Boris Fehse from the University Clinic Hamburg-Eppendorf and Dr. Thomas Stübig from the University Clinic Kiel will give insights into their work.

Following the two presentation there will be time for open questions and discussion with our two presenters.
 

Monitoring of CD19 CAR T cells by digital PCR and flow cytometry 

Presenter: Prof. Dr. Boris Fehse 

Immunotherapy with CD19 specific CAR T cells has shown excellent efficacy in late-stage B cell cancers. In vivo expansion and persistence of CAR T cells after infusion are important response- and toxicity-determining variables, but standardized diagnostic tools for CAR T cell monitoring have not been widely implemented outside clinical trials. In this webinar we will report on: 

• Application of novel digital PCR (dPCR) assays and flow cytometry (FC) for monitoring of axi-cel and tisa-cel CAR T cells in vivo.
• A prospective monitoring scheme in 21 consecutive real-world axi-cel treated patients, which showed a significant association between in vivo CAR T peak values and treatment outcome.
• The very good correlation between dPCR and FC data supporting the high diagnostic value of both methods.

In conclusion, CAR-specific dPCR and FC assays are excellent complementary tools to monitor infused CAR T cells in real-time in different body tissues.
 

The other side of CAR T-cell research – from bedside to bench side

Presenter: Dr. Thomas Stübig

CAR T cells have changed the treatment of B cell lymphoma and B cell leukemia. As many patients benefit from this innovative therapy approach there is a significant number of patients who are non-responding to CAR T cell treatment. Analyzing CAR T cells could help identify factors that are accountable for response, but also for non-response to this therapy. Three major practical topics on isolating CAR T cells for research use will be discussed:

• Pre-analytical issues like sample volume, timetables, and the necessity of close communication with clinical partners.
• The analytic process: protocol of enrichment, efficiency of CAR T cell enrichment and aspects of troubleshooting.
• The results: quality and quantity of enrichment and quality of DNA/RNA for down-stream analysis.