July 28, 2016
1 min read

Checkpoint inhibitor therapy more economical, safe than CAR T cells in pediatric leukemia

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Novel advances in the use of checkpoint inhibitors – such as an anti-PD1 or anti-PDL1 – to treat pediatric leukemia may result in the ability to eliminate the use of CAR T-cell therapy in that patient population in the future, according to Donald Durden, MD, PhD, vice chair for research at UC San Diego’s Department of Pediatrics and associate director for pediatric oncology at the Moores UCSD Cancer Center.

“Once we figure out how to use checkpoint inhibitors along with targeted therapies, we’re going to be able to actually execute a cure of childhood cancer – including leukemia and solid tumors,” Durden told HemOnc Today. “[We’ll also be able to use] something that is a lot less risky than CAR T-cell technology, which of course has significant toxicity.”

Donald Durden

Donald Durden

Although CAR T-cell therapy has “revolutionized” the treatment of cancer, the use of chemotherapy and radiation to treat children with leukemia is associated with long-term side effects that include heart failure, growth delay and neurocognitive delay, Durden said.

“Patients who get CAR T-cell technology usually go to the pediatric ICU and they’re usually very sick for at least a week or two and it’s not … an innocuous therapy, whereas giving a checkpoint inhibitor is actually well tolerated,” he said. “Essentially, you can give that in the clinic every three weeks and the child goes home and [can continue] to live a normal life at home.”

Since the immune system is designed to regulate itself, the use of checkpoint inhibitors – instead of CAR T cells – has the ability to circumvent the “off-switch” for the immune system, Durden said.

The addition of medication or the infusion of an anti-PD1 or anti-PDL1 inhibitor could then activate the immune system to treat childhood cancer with minimal side effects, he said.

“[CAR T cells] are useful modalities, but what would be best for all concerned patients and society would be to have a therapy that has no toxicity, but actually does cure the patient,” he said. “The nice thing about immunotherapy is that you activate the immune system, it’s a durable response.” – by Ryan McDonald

Disclosure: Durden reports no relevant financial disclosures.