Autologous T cells expressing CD30 chimeric antigen receptors for relapsed or refractory Hodgkin lymphoma: an open-label phase 1 trial

Autologous T cells expressing CD30 chimeric antigen receptors for relapsed or refractory Hodgkin lymphoma: an open-label phase 1 trial
Hodgkin lymphoma (HL) is typically CD30 positive. The authors were looking for a novel treatment for relapsed or refractory disease. CD30 targeting CAR-T cells have not been described prior to this report. This is a phase 1 study describing the feasibility, safety and efficacy of CD30 targeting CAR-T cells.
18 patients with relapsed or refractory HL between the ages of 13-77 years with CD30+ disease (17 HD, 1 ALCL). Patients received one of three conditioning regiments (fludarabine/cyclophosphamide, gemcitabine/cyclophosphamide or paclitaxel/cyclophosphamide) with subsequent infusion of CAR-T cells given over several days. They were eligible for a second infusion of CAR-T cells at recurrence if they had an initial response.
Of 18 patients enrolled, 14 had refractory disease, 4 had relapsed disease that was refractory to prior treatment. There were 2 grade 3/4 toxicities - one patient with elevated ALT, and one with decreased left ventricular systolic function. One patient had anaphylaxis. Out of the 18 patients, there were 7 partial responses and 6 with stable disease. Five patients were previously treated with brentuximab, 1 had PR and 2 had SD after CAR-T cells. Lymph node regions responded the best, lung lesions responded poorly.
Varying conditioning regimens were used prior to infusion. Study included patients who have failed previous CD30 targeted therapy (ie brentuximab), but there were some patients with response. These cells are specifically engineered for the patient, and this is difficult to make available widely.
CD30 targeted CAR-T cells are safe to give and show some efficacy in relapsed/refractory CD30+ve Hodgkin lymphoma in this phase 1 study. Additional studies are needed to further characterise their role in therapy for Hodgkin lymphoma.