Day 4 of the ASH Meeting & Exposition featured the Presidential Symposium highlighting the p53 protein, a tumor suppressor protein known as the guardian of the genome. TP53 is known as the single most frequently altered gene in cancers, with mutations in approximately 50% of all invasive tumors.
A highly-esteemed panel of hematologists took the audience on a journey through mutant p53 history, as Dr. Carol Prives relayed the function and complexity surrounding tumor suppression and inhibition. Dr Guillermina Lozano discussed mechanisms of tumor cell addiction to mutant p53. Dr. Matthew Davids highlighted current therapeutic strategies to inhibit or reactivate mutant p53 and its pathway in acute and chronic hematologic malignancies, including disease control, downstream targeting, combination approaches, immune-based therapies, and restoring wild-type p53 function.
Many exciting late-breaking abstracts were presented and we couldn’t include them all here, but below are a couple of highlights around CAR T-cell Therapy:
- Abstract 566 – Diversity in clinical trials: Highlighting the emphasis this year on diversity, equity, and inclusion, a retrospective analysis of seven pivotal clinical trials leading to the approval of current CAR T-cell therapies was evaluated for inclusion by demographic subgroup. While it is well-known that patients of the African diaspora are underrepresented in clinical trials in hematology/oncology, Dr. Al Hadidi and co-authors found this to be true for CAR-T therapy trials, particularly in multiple myeloma, which disproportionately affects the African diaspora. Echoing a common theme from the anti-racism studio and DEI sessions, inclusion from the start is essential.
- See how PlatformQ Health is tackling the diversity gap in clinical trials in partnership with LUNGevity, starting with a program addressing clinical trials for lung cancer.
- Abstract 567 – Financial toxicity: From the introduction of CAR-T therapy into the treatment armamentarium, cost has been a focus of clinical discussions. While significant progress has been made, this therapeutic option may still be associated with financial toxicity for patients due to therapy costs and costs associated with travel. In this mixed methods longitudinal study, the authors describe the results of the study, which utilized the Comprehensive Score for Financial Toxicity (COST-FACIT) questionnaire. \
- Abstract 741 – CD-22 CAR-T therapy. After failure of CD19-directed CAR T-cell therapy, patients with relapsed/refractory LBCL have a poor prognosis. As CD22 is expressed in the majority of B-cell malignancies, Dr. Matthew Frank and colleagues sought to investigate autologous CAR T-cells targeting CD22 (CAR22) in patients with CAR19-refractory disease. While a phase 1, the results are encouraging, demonstrating that the CAR22 infusion in relapsed/refractory LBCL is safe and well tolerated at dose level 1, with an overall response of 86% and complete response of 67%. Based on this data, CAR22 can be considered as salvage therapy for CAR19-refractory or CD19-negative LBCL.
Patient COST-FACIT baseline scores revealed higher initial financial well-being while the range of scores indicated that patients enter CAR-T therapy at different levels of financial toxicity. The authors report financial well-being declining post-therapy, with qualitative themes of insurance, lodging/relocation, work/income, and non-traditional sources of funding being reported via interviews. These data provide insight into the patient experience with CAR-T therapy, and can inform strategies that address hesitance to utilize CAR-Ts due to financial concerns.
- In 2020 PlatformQ Health partnered with Triage Cancer to provide a patient education series on addressing financial concerns related to cancer treatment.
As our #ASH21 blog comes to a close, the hematology community has much to look forward to with a plethora of clinically relevant data, emerging novel therapies, a better understanding of mechanisms of resistance that can lead to new therapeutic strategies, and a strong commitment from the leading hematology organization to address disparities and ensure equity. Thank you for taking this trip with us. Stay tuned for 2022 programs on OMEDLive and CancerCoachLive that share these updates and more to ensure clinical translation, and empower patients with the latest information.
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