André Goy’s Post

Transcript

Once again this year I'm Chantara Cancer Center is very proud to present and to be part of a / 70 abstract and and the presentation at ASH. And for our audience, the ASH meeting is the annual Hematology International meeting. This is the largest blood cancer meeting and we're very excited to have all these presentation. It does reflect on the scope and breadth and and and death of our program here as a destination blood cancer program. So when you have so many abstract, I think one of the best way to do is actually to. Is actually to group them in by topics and I think that. The first one is really around Karti cells abstract and cell therapy county cell is the most transformative therapy in over 30 years in lymphoma and leukemia and then some Epidata dash that there's. Around the conditioning regimen that we use for CAR T cells looking at bananas in versus cytotoxin and the reason is that there was a shortage of herbine. So there were more patient treated with menacing. And we have a study, internal study that shows from our group here with doctor Donado and a team that shows that there's a higher complete response rate with fludarabine and cytoxan compared to banana mustin. This has been also reported by some. The group and there's a large study with doctor Ali Allah from Georgetown that actually looked at a very large registry study and that showed that there was no there's also over 5000 patient. There was also a higher responses with Friday being based conditioning regimen then by the machine, but it did not seem to really impact significantly the long term outcome. And preferably we like to use a food Arabian and that's part of outstanding care here. I think the second thing that was important after the conditioning is the efficacy of date. So we have multiple abstract people don't trials particularly the study presented by doctor. Laurie Leslie that he's presenting the update on the Zuma 5 trial which is a long term Karti cells Axon cell in for the relapse of factory for the killer lymphoma that we have double refractory with a 60 mile table survival of over 69% which is really good. We also have an update of long term of Zuma 2 trial which was in metals and lymphoma that's also shows a very high 60 month. Overall survival rate comparing to recycle control. This is dramatically different and it shows that Bishop and menus and lymphoma significant patient on his patient who who achieve CR at the beginning actually are likely cured with very very few late relapses and no additional toxicity. And there was a, there's a study presented also with Doctor Feldman and Doctor Leslie looking at CL cartee cells, which have not been as successful as in other lymphomas and because of the rationale of the impact of yeah, Brittany born. T cells, but also the macro environment and skewing towards a better response and with the T cells the combination with Albritton neighbor was noticed the patient who had been on abortion neighbors use other BTK inhibitors when they receive car T cells need better. So this led to a trial that news. This combination with Lisa cell and antacid 19 carticel well tolerated and showing a much better CR rate. And better outcomes. So this is something that is continuing to be meaningful in that setting. And there was a a large study looking at. Understanding better the efficacy because we cure let's say aggressive lymphoma and metals and lymphoma, we cure a fraction of patients and you know high 30 to 40% long term. And the idea is to try to understand biomarkers that would help identify the patients that do well. So there was an interesting study looking at 160 patient with a reliable Archer lymphoma. And funds gene signature that could identify a progression for survival of less than three months versus 75% at 18 month. And then that's dramatically different. So this is early, but this is offering direction trying to identify the patient that would be doing the best on Cartesian. And finally, there was a cohort that is going to be presented that were studied looking at patient on Brexit cell on the Zuma. To that we are BTK neither because the original data looked at on agricultural and patient who had failed chemo, immunotherapy and BTK inhibitors. But there were some patient in this cohort 3 there were mitigating I even showing again very high CR rate in excess of 70% and very promising result. Although the follow up is not as durable and long as the. As the original Zuma 2 trial other cohort and showing that basically Carty and Brexit cell is a show similar efficacy and toxicity profile in a patient who are bikini. We also have a presentation from GDC looking at new ways to improve on cell therapy, exploring particularly ways to increase the durability of T cells so to either prevent the differentiation of those T cells toward memory cell or to reduce their the exhausting factor in T cells. So there's some interesting Lamb from CDI and using Lamb and collaboration with us looking at. Um, on how we can improve the stemness and durability of those CAR T cells and also improve the efficacy by combining with the silica inhibitors and epigenetic therapy to improve their stemness and the durability of those CAR T cell. As I just mentioned, this isn't a preclinical setting, but this could really offer an opportunity to improve the outcome on patient with Carty cells in lymphoma and we have an ongoing study that is starting with CDI. Looking at a patient who are standard of care and looking at extensive genomics and inflammatory and immune profiling and hopefully microbiome as well to try to identify who is in this long term curve eventually. And finally in cell therapy. I would say that there's an interesting opportunity in Hodgkin lymphoma that typically patients do well, but there's a fraction of patients that relapse and even after hydrotherapy and. Transplant and who don't have great options because cortisol has not worked well so far in in Hodgkin lymphoma and there's a study that is ongoing that we participate that will be presented at ASH looking natural killer cells and with antibodies that are targeting Hodgkin lymphoma cells with very preliminary but promising results. And then there's a large intergroup study, it's a global study looking at the outcome of patient who failed CAR T cells in mental cell lymphoma and the result usually the survival is very dismal except maybe with a subset of patients receiving bispecific antibody. But the take home message of this abstract is really that we need to refurbish and As for Carter cell therapy early in the course of mental cell lymphoma because they do perform. Better because they have better T cell fitness, less disease, less toxicity etcetera. So I covered quite a few obstruction lymphoma. I will also cover former GCC and there were two abstract looking at CAR T cells early on in a lot of therapy in multiple myeloma with very promising. MRD negativity, So molecular responses. Not a very long follow up, but a very, very interesting and. And much less delayed neurotoxicity as well. And then there was an ongoing study that is looking at actually losing using Carty cells as a consolidation in a patient who not who do not achieve an adequate response to the induction standard therapy in myeloma. And then in the AML setting also caught T cells and NK cells have not really pan out so far in that disease. But we have a really fascinating study that actually is open here where we use CD33 negative modifier stem cells to regenerate hematopoiesis as part of transplant and then with the ability to use a CAR T cell approach anti CD33 afterwards. I would therefore would not affect the rest of the hematopoiesis and could be really the 1st. Really breakthrough in AML refractory disease in that setting. So a lot going on in CAR T cells. There's a lot of other CAR T cell dual car T very short manufacturing CAR T cells and off the shelf CAR T cells that are being going to be presented at ASH and is continuing to expand their field of cell therapy in he malignancies and truly transforming the disease because the advantage of this therapy. The one end time done treatment and I think we're going to more and more see this in a field of oncology, not treat patient for extensive period of time, but really give them the opportunity of A1 and done therapy. Switching in now on a bicyclic antibody, which is not an antibody, it's a small molecule that could I could force the bridge immunological bridge between a T cells and the tumor cells. So this biospecific multiple abstract Cadash showing for example most user map. Even though she did 20 um by C peak showing in follicular lymphoma very high in Europe all response rate and also in a fixed duration and eco retamar which is another by specific and rituximab. The patient with the relapse of factory follicular lymphoma with very impressive again durable response with 87% irrespective of the early progression in those patient and and doing really well, very high CR as I mentioned. Regardless of the harvest features and the early progressors. There was also on the advice specific three years update on the NHL one trial in the relapse of factor relation lymphoma. And that's again showing that in a patient who had achieved the CR and there was a clear subset of patient that had not progressed with a plateau and offering for the first time potentially for limited therapy and the ability to potentially cure some of these. And would very specific. And then Doctor Leslie is also presenting Ecourier Tamav and Armani Champ, which is combining these bispecific antibodies in combination with chemoimmunotherapy, but a lower dose in patients who are not eligible for chemotherapy, elderly, frail and showing that. 91% of these fish are still incomplete response at 12 month. This is extremely encouraging. This patient who are not great carnival chemotherapy would not have done well with standard chemoimmunotherapy. And then on the. Third topic that I would say that is important as part of the abstract of a Junker Cancer Center, several abstracts looking at stratification of patients with multiple myeloma with gene signature better than Saturn genetics and FISH as qualification and a lot of studies looking at next Gen. sequencing that shows several interesting features in particular show that you have both immune signature but obviously suffered. And they somebody musician profile that have varying by tops of lymphoma and among patients but immune signature that seem to be sort of lymphoma subtype specific and offering upon another opportunity for the future for treatment. And then finally in a novel therapy briefly as a four topic while answer microvia with a radio isotope and that is remarkable local foreseen iodine 131 that. He's offering in a population that really has an unmet need after feeling BTK anti CD 20 therapy alkylating agent with banana mustin proteasome inhibitors showing response rate in excess of 80%. And I think this is offering something that is also a one and done treatment very appealing. So this is obviously just a quick overview of all the abstract presented by GTC at ASH and I'm very proud of the team. This is our largest number of abstract ever, and it continues to be a testimony to the. Continuation of progression of our Blood. Mentor program at John Tory Council Center. Thank you.