Cell Therapies for Patients With NSCLC
A key opinion leader in thoracic oncology discusses factors to consider regarding emerging cell therapy options in non–small cell lung cancer, such as CAR T, TCR, and TIL therapies.
Adam J. Schoenfeld, MD: Cell therapy is a broad term that involves multiple types of therapies, such as CAR [chimeric antigen receptor] therapy, where you reprogram a patient’s own immune cells to target specific proteins in the patient’s body. Another type of cell therapy, TCR [T-cell receptor] therapy, similarly targets antigens throughout a patient’s body. TIL [tumor-infiltrating lymphocyte] therapy is a separate type of therapy that uses a patient’s own immune system that has already identified a patient’s cancer cells and reinfuses those cells to target and control a tumor.
Cell therapies have had remarkable success in blood cancers like leukemia or lymphoma. Patients may have heard of things like CAR T cells, which have been very helpful in treating leukemias, and are emerging therapies in lymphoma and multiple myeloma. In lung cancer, we’re very much in the earlier stages of cell therapy in regard to solid tumors. These include CAR, TIL, and TCR therapies.
The advantages and limitations with cell therapy in non–small cell lung cancer are hopefully similar to what we’ve seen with other immunotherapies that are approved in lung cancer and other solid tumors. By harnessing the power of a patient’s own immune system, it can potentially be an extremely effective tool to achieve disease control over possibly long periods. One of the disadvantages is that lung cancer is a very complex disease. There are multiple different mutations the tumor can have, and the tumors evolve over time. Picking 1 target for cell therapy might not be effective, or might only be effective for a short time. We also have to learn more about the safety of these drugs. Because we’re in early phase clinical trials for many types of cell therapies in the solid tumor setting, we do not know the full safety profile of these therapies.
When we think about therapeutic options, in every setting with every type of therapy, we have to think about a patient’s context, what prior lines of therapy they have received, and what their goals are. That also applies to cell therapy. We have to think about the clinical characteristics of each patient as well as the potential molecular alterations of their tumor to see if there are potential targets we can identify to use cell therapy.
Transcript edited for clarity.
