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Two groundbreaking clinical research studies designed to assess the effectiveness of CAR-T cell therapy on lupus and multiple sclerosis are under development at Swedish.
CAR-T cell therapy is currently used to treat blood cancers — often with outstanding results. Autoimmune experts at Swedish are cautiously optimistic they’ll see similar results for people with lupus and multiple sclerosis.
Treatment protocols for the clinical trials were based on successful outcomes using CAR-T cell therapy to treat people with blood cancers.
Groundbreaking. Life-changing. Potential cure.
Words like these are not used every day — or even very often — when describing new treatments in health care. But researchers are hoping several clinical studies currently underway at Swedish will make them a regular part of the conversation when discussing treatment options for people with lupus and multiple sclerosis (MS).
Two clinical research studies that look at using CAR-T cell therapy to treat lupus and multiple sclerosis are in the early stages of development at Swedish. Researchers are cautiously optimistic that the new use for a therapy with benefit in blood cancers could lead to life-changing results in lupus and MS. The lupus trial is currently open for enrollment with the MS trial expected to begin enrolling patients early next year.
“We are taking a type of treatment (CAR T-cell therapy) that has a proven benefit for blood cancer patients and applying it in structured clinical trials to patients with lupus and MS. We are very much at the beginning of that experience with these conditions, but the type of treatment itself has been well studied and applied in other diseases,” said Krish Patel, M.D., director of Hematologic Malignancies and Cellular Therapy at the Swedish Cancer Institute’s Center for Blood Disorders and Cellular Therapy.
“If this works, it could potentially bring us within striking distance of curing multiple sclerosis,” said Pavle Repovic, M.D., Ph.D., neurologist and medical director for Neurology research at Swedish. “I’ve been at Swedish since 2010, and this is the most exciting study I’ve seen in 13 years. There have been some good ones, but this really is . . . WOW. Hopefully it works.”
Building on past success
In both upcoming studies, researchers will administer CAR-T cell therapy as treatment for lupus or MS, depending on the study. CAR-T cell therapy is a form of immunotherapy that, until now, has been primarily used to treat blood cancers. This innovative treatment has been available at Swedish Cancer Institute since 2018 with more than 130 patients receiving CAR T-cell therapy.
“We take living immune cells and reengineer them so they can find and kill a specific type of cell in the patient’s body. Then we infuse those altered CAR-T cells into the patient, where they will grow and multiply to create a small army that attacks the target cells,” explains Dr. Patel.
The treatment has been very successful for many patients who had little hope of a successful outcome otherwise.
“Relapsed or refractory Large B cell lymphoma was essentially a death sentence before the advent of CAR-T cell therapy. Now we cure about 30-40% of patients in that circumstance,” said Dr. Patel. “CAR-T therapy may or may not be curative depending on the disease we are treating, but it often provides prolonged disease remissions of two to four years when other therapies would be expected to have a median progression-free survival of six to 12 months. So they are complete game changers in our world of blood cancers.”
Innovative treatment brings life-changing results
The upcoming lupus study comes on the heels of successful research done recently in Germany.
“A little over a year ago, I was talking to a friend who is the chief of a very prominent rheumatology unit in Germany about CAR-T cell therapy, and he said, ‘Why not? Let’s try CAR-T therapy in lupus.’ So he tried it in five patients, and it was a spectacular experience with very safe outcomes and no major adverse events,” said Philip Mease, M.D., director of rheumatology research at Swedish.
“And now, a little over two years later, the longest observed patients are in complete — I mean, absolutely complete — drug-free remission of their disease. No signs of lupus,” adds Dr. Mease. “We’re hoping for similar results.”
Multiple sclerosis experts are also filled with “enthusiasm and hope,” according to Dr. Repovic.
“The CAR-T cell trial in multiple sclerosis will be the first of its kind,” he explains. “There are currently several FDA-approved medications used to treat multiple sclerosis, but they need to be given repeatedly, from twice a day to several times a year. This therapy holds the potential of being given once. The hope is that this treatment will be more effective and more comprehensive.”
“I really want to be very careful and cautious about calling anything a cure because there have been so many false starts and hopes along the way. But imagine if you could just get one treatment and have no future MS attacks or disease activity. There’s still a lot of work to be done. Restorative and regenerative therapies still have a long way to go. But if we can at least stop the onslaught long term, that would be amazing.”
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