CCSC: Full-process management, detailed secrets of CAR-T in the clinical treatment of blood diseases

Chimeric antigen receptor T cell (CAR-T) therapy, as a disruptive innovative therapy, is booming in China
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On June 22, 2021, Yikaida® (Akilunza injection) was formally approved by the National Medical Products Administration (NMPA), becoming China’s first CAR-T therapy drug targeting CD19 for the treatment of previously accepted drugs Adult patients with relapsed or refractory large B-cell lymphoma (R/R LBCL) after second-line or above systemic treatment have brought new treatment options for R/R LBCL
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At present, it has been approved in 38 countries around the world, and has accumulated nearly 5,000 patient experience
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In order to promote the development of China's CAR-T field, build China's CAR-T star treatment center, and cooperate with international and domestic diagnosis and treatment
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"CCSC (China CAR-T Star Center)-Kylinhui International Connection" continues! September 15, 2021-The new phase of the Kylin Club International Connection was successfully held in Beijing
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This conference has the honor to invite Professor Yang Shenmiao from Peking University People’s Hospital, Professor David B.
Miklos from Stanford University Medical Center, Professor Wang Fengrong from Peking University People’s Hospital, and Professor Tang Feifei from Peking University People’s Hospital as speakers and discussion guests, focusing on CAR-T For cutting-edge topics in the field of cell therapy, we will conduct in-depth discussions and exchanges on Fosun Kate’s CAR-T cell therapy drug Yikaida® (Akirensai injection)
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Below, I will take you to review the wonderful links of this conference.
I hope that this conference can expand clinicians' understanding of the clinical efficacy of Akirensai injection and further improve the clinical benefits of patients
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Looking at CAR-T clinical practice skills from the perspective of full-process management This session was delivered by Professor Yang Shenmiao from Peking University People’s Hospital entitled "CAR-T full-process management strategy"
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Professor Yang Shenmiao gave a detailed introduction to the necessity, specific process, and adverse reaction management of CAR-T treatment
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The specific procedures include pre-treatment evaluation and patient identification, and comprehensive multidisciplinary management during treatment (including apheresis, bridging therapy, cell preparation, infection prevention and control after lymphoblastic chemotherapy, preparation before reinfusion, and reinfusion) Overall management after treatment), long-term monitoring and follow-up after treatment
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Professor Yang Shenmiao said that a CAR-T treatment management platform should be established with patients as the center to provide all-round management throughout the process
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From international research experience, CAR-T's new solution for relapsed and refractory lymphoma Report
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Professor David B.
Miklos introduced the advantages of CAR-T therapy compared with traditional tumor therapy: it expands the patient population, is more effective, and is more durable
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The ZUMA-1 study shows that CAR-T therapy has significant survival benefits, with a 4-year overall survival rate (OS) of 44%
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Compared with real-world data, Akirensai injection maintains a consistent efficacy in disease remission.
The objective response rate (ORR) is basically around 80%, and the complete remission rate (CR) is maintained at around 50%; in terms of survival, 3 The annual OS rate remains at around 50%, and the real-world data is even slightly higher than the ZUMA-1 research results
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Professor David B.
Miklos made a horizontal comparison of current CAR-T therapeutic drugs.
Akirensai injection has a significant advantage in remission rate, but the adverse reactions, especially cytokine release syndrome and neurotoxicity, have a higher incidence
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At the same time, Professor David B.
Miklos shared his experience in CAR-T treatment process, the impact of ECOG score on patient survival, adverse reaction management, and possible causes of treatment failure
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He believes that the decrease in CD19 expression is closely related to disease recurrence, and dual targets may be more advantageous than single targets
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Experts talked together and discussed the sharing of Professor Yang Shenmiao and Professor David B.
Miklos
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Professor Tang Feifei from Peking University People's Hospital asked questions about the role of CAR-T in the central nervous system, the management of cytokine release syndrome, and the choice of CAR-T and other drugs
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Professor David B.
Miklos stated that doctors should be vigilant against the adverse effects of neurotoxicity after CAR-T treatment.
Once they occur, they should take medication in time to effectively improve symptoms and avoid further deterioration; the occurrence of cytokine syndrome is related to the patient’s own Tumor burden, patient age, treatment before CAR-T treatment and other factors are related, and need to be considered comprehensively.
At present, there are more trials of combination therapy in CAR-T treatment, and further research results are expected
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Professor Wang Fengrong from Peking University People's Hospital raised questions about CAR-T intensive consolidation therapy and the treatment of relapsed patients
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Professor David B.
Miklos said that targeted therapy can have a certain enhancement effect on CAR-T therapy.
At present, relevant research is in progress, and more positive results are expected; for patients with relapse, a second infusion or other second-line treatments can be selected The specific medication should depend on the patient's condition
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Professor Yang Shenmiao and Professor David B.
Miklos conducted in-depth explorations on the cost of CAR-T treatment, the choice of combination drugs, the choice of new drugs, and the CAR-T dose division between China and the United States
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Professor David B.
Miklos said that dose division currently has no obvious advantages in clinical efficacy, but it has certain advantages in toxicity management
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At the same time, in terms of the financial burden of patients, Professor David B.
Miklos said that the current CAR-T treatment is more expensive, but I believe that in the near future, with the development of more and more clinical trials, the situation will get better and better
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Summary At the end, Professor Yang Shenmiao made a summary of the meeting
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Professor Yang said that with the support of Fosun Kate, the multi-stage Kirin Club international connection was successfully held, which provided a bridge for in-depth communication and exchanges between domestic and foreign experts, and also provided more lessons for the clinical use of CAR-T.
He hoped CAR-T treatment can bring more hope to Chinese patients
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The meeting ended successfully in the heated discussion of experts and scholars! Poke "read the original text", we make progress together