Key clinical point: Unintentional transduction of a single leukemic B cell induced resistance to CTL019 (tisagenlecleucel) therapy.
Major finding: A patient with B-cell acute lymphoblastic leukemia (B-ALL) had frank relapse 9 months after a CTL019 infusion, with more than 90% bone marrow infiltration of chimeric antigen receptor–transduced B-cell leukemia cells.
Study details: A case study of a 20-year-old male with B-ALL undergoing CTL019 therapy.
Disclosures: Study funding was provided by Bristol-Myers Squibb, Novartis, the National Institutes of Health, and others. Dr. Ruella and several of his colleagues work under a research collaboration involving the University of Pennsylvania and the Novartis Institutes of Biomedical Research and are inventors of intellectual property licensed by the University of Pennsylvania to Novartis.
Ruella M et al. Nat Med. 2018 Oct 1. doi: 10.1038/s41591-018-0201-9.
This Week's Must Reads
Program reduces ER admissions and inpatient costs, Mendenhall M et al. Quality Care Symposium, Abstract 30
Pain severity decreased over time with app, Kamdar MM et al. PallOnc 2018, Abstract 76
National health care spending growth slowed to 3.9% in 2017 , Martin A et al. Health Affairs. 2018. doi: 10.1377/hlthaff.2018.05085
Medicare Part D rules on protected medication classes could change, Federal Register (83 FR 62152)
Federal proposal aims to move doctors back to face-to-face interventions, Office of the National Coordinator for Health IT
Must Reads in Immuno-oncology
Lenvatinib plus pembrolizumab shows promising activity in NSCLC, Brose M et al. SITC 2018, Abstract P392
NGS may ID SCLC candidates for immunotherapy, SITC 2018
Monalizumab + cetuximab is active in advanced SCC of the head and neck, Cohen R et al. SITC 2018, Abstract 051
Nivolumab boosts survival over chemo for advanced melanoma, Ascierto PA et al. JAMA Oncol. 2018 Oct 25. doi: 10.1001/jamaoncol.2018.4514
Checkpoint inhibitor combo continues to show benefit for advanced melanoma, Hodi FS et al. Lancet Oncol. 2018 Oct 22. doi: 10.1016/S1470-2045(18)30700-9