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Chimeric antigen receptor T cell (CAR-T) therapy, as a disruptive innovative therapy, is booming in China
.
On June 22, 2021, Yikaida® (Akilunza injection) was officially approved by the National Medical Products Administration (NMPA), becoming China’s first CAR-T therapy drug targeting CD19 for the treatment of relapse/ Adult patients with refractory B-cell lymphoma (R/R LBCL) bring new treatment options for R/R LBCL
.
At present, it has been approved in 38 countries around the world, and nearly 5,000 patients have experience in use
.
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
.
"CCSC (China CAR-T Star Center)-Kylinhui International Connection" continues! The Union Hospital affiliated to Huazhong University of Science and Technology has taken the lead in completing the collection of commercial products in China.
In order to further promote the clinical safety management of CAR-T treatment, it is specially connected with the internationally renowned CAR-T clinical management team to exchange experience
.
Professor Hu Yu from Union Hospital Affiliated to Huazhong University of Science and Technology served as chairman; Professor Xia Linghui and Professor Mei Heng from Union Hospital Affiliated to Huazhong University of Science and Technology chaired the conference; Dr.
Sattva S.
Neelapu from the University of Texas Anderson Cancer Medical Center was invited to interpret CAR-T international clinical Application; and Professor Mei Heng from Union Hospital of Huazhong University of Science and Technology shared the Kirin collection: an introduction to CAR-T research in Wuhan Union Hospital; focusing on the progress and management of CAR-T at home and abroad, together bringing us an academic gluttonous feast
.
Promotion of CAR-T domestic clinical progress and management In this session, Professor Mei Heng from Union Hospital of Huazhong University of Science and Technology shared a theme introduction entitled "Introduction of CAR-T development in Wuhan Union hospital"
.
Professor Mei Heng introduced three aspects of the current CAR-T clinical trial overview, CAR-T translational research and CAR-T clinical management in Wuhan Union Medical College Hospital
.
He pointed out that Wuhan Union Hospital has currently carried out more than 20 clinical trials, with a total of 207 patients receiving CAR-T cell reinfusion, with a total remission rate of 89.
74%, and the longest disease-free survival period has exceeded 5 years
.
In terms of CAR-T transformation research, the clinical research program (ChiCTR1800018143) of CAR-T cells targeting BCMA and CD38 for the treatment of relapsed and refractory multiple myeloma (RRMM) has achieved good efficacy, good safety and controllable adverse reactions
.
In terms of clinical management, Wuhan Xiehe first proposed CRS-related coagulation disorders, and Professor Mei Heng shared the clinical management experience of CAR-T therapy-related toxic and side effects through clinical trials
.
Drawing lessons from CAR-T international clinical application and management experience.
In this session, Dr.
Sattva S.
Neelapu from the University of Texas Anderson Cancer Medical Center shared a theme introduction entitled "Clinical application of CAR-T in DLBCL: International perspective"
.
Dr.
Sattva S.
Neelapu mainly introduced ZUMA-1 clinical research progress and case reports
.
Dr.
Sattva S.
Neelapu said that tumor burden is closely related to the efficacy and toxicity of CAR-T treatment.
With the increase of tumor burden, the ORR at one year does not change much, and the sustained remission rate gradually decreases.
The incidence of CRS and NEs of grade 3 or above It is the smallest when the tumor burden is low
.
The late toxicity after CD19 CAR-T cell treatment mainly includes late neurotoxicity such as temporary aphasia and seizures, hemophagocytic lymphohistiocytosis (HLH), grade 3 or above cytopenia, and B cell hypoplasia
.
Due to persistent B cell hypoplasia and T cell immune reconstitution data after fewer cell treatments, it is recommended that patients with HBV or HCV lymphoma continue long-term antiviral prophylaxis
.
In the discussion session of CAR-T treatment thinking collision, Professor Cui Guohui of the Union Hospital of Huazhong University of Science and Technology raised questions about the start time of CAR-T treatment in Case 1.
Dr.
Sattva S.
Neelapu said that the ZUMA-7 trial for second-line treatment of lymphoma (Axi -Cel) and TRANSFORM trials (Liso-Cel) showed favorable trends, while another BELINDA clinical trial (Tisa-Cel) for the second-line treatment of B-NHL did not reach the primary endpoint EFS, which means the phase 3 study failed
.
At present, the data is still immature and cannot be used as a second-line treatment for the time being.
In the future, based on the above-mentioned two beneficial clinical research results, CAR-T therapy is likely to be approved as a second-line treatment for relapsed and refractory lymphoma
.
Professor Mei Heng from Union Hospital of Huazhong University of Science and Technology raised questions about the efficacy of CAR-T as a second-line treatment.
Dr.
Sattva S.
Neelapu said that the structure and toxicity of Axi-Cel, Tisa-Cel and Liso-Cel are slightly different, and the remission rate is not high
.
Compared with Tisa-Cel, Axi-Cel has better clinical effects and shorter cell preparation time
.
The structure of Liso-Cel uses 4-1BB costimulatory molecules, which has good clinical safety and is milder than CD28 molecules
.
Professor Zhang Lu from Union Hospital of Huazhong University of Science and Technology raised questions about the first-line treatment of CAR-T.
Dr.
Sattva S.
Neelapu stated that patients showed clinical benefit and controllable safety in the ZUMA-12 clinical study of Axi-Cel first-line treatment of high-risk LBCL Compared with ZUMA-1, CAR-T cells in ZUMA-12 express higher CCR7 and have more undifferentiated phenotypes.
This is related to the expansion of CAR-T in vivo, indicating that CAR-T cells are in the earlier first-line Or the adaptability of second-line treatment is better
.
Summary At the end, Professor Mei Heng made a summary of the meeting
.
Professor Mei expressed his gratitude to Dr.
Sattva S.
Neelapu for his online report, and hoped to discuss the new CAR-T program at home and abroad to benefit more patients offline as soon as possible
.
The meeting ended successfully in the heated discussion of experts and scholars! Poke "read the original text", we make progress together
.
On June 22, 2021, Yikaida® (Akilunza injection) was officially approved by the National Medical Products Administration (NMPA), becoming China’s first CAR-T therapy drug targeting CD19 for the treatment of relapse/ Adult patients with refractory B-cell lymphoma (R/R LBCL) bring new treatment options for R/R LBCL
.
At present, it has been approved in 38 countries around the world, and nearly 5,000 patients have experience in use
.
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
.
"CCSC (China CAR-T Star Center)-Kylinhui International Connection" continues! The Union Hospital affiliated to Huazhong University of Science and Technology has taken the lead in completing the collection of commercial products in China.
In order to further promote the clinical safety management of CAR-T treatment, it is specially connected with the internationally renowned CAR-T clinical management team to exchange experience
.
Professor Hu Yu from Union Hospital Affiliated to Huazhong University of Science and Technology served as chairman; Professor Xia Linghui and Professor Mei Heng from Union Hospital Affiliated to Huazhong University of Science and Technology chaired the conference; Dr.
Sattva S.
Neelapu from the University of Texas Anderson Cancer Medical Center was invited to interpret CAR-T international clinical Application; and Professor Mei Heng from Union Hospital of Huazhong University of Science and Technology shared the Kirin collection: an introduction to CAR-T research in Wuhan Union Hospital; focusing on the progress and management of CAR-T at home and abroad, together bringing us an academic gluttonous feast
.
Promotion of CAR-T domestic clinical progress and management In this session, Professor Mei Heng from Union Hospital of Huazhong University of Science and Technology shared a theme introduction entitled "Introduction of CAR-T development in Wuhan Union hospital"
.
Professor Mei Heng introduced three aspects of the current CAR-T clinical trial overview, CAR-T translational research and CAR-T clinical management in Wuhan Union Medical College Hospital
.
He pointed out that Wuhan Union Hospital has currently carried out more than 20 clinical trials, with a total of 207 patients receiving CAR-T cell reinfusion, with a total remission rate of 89.
74%, and the longest disease-free survival period has exceeded 5 years
.
In terms of CAR-T transformation research, the clinical research program (ChiCTR1800018143) of CAR-T cells targeting BCMA and CD38 for the treatment of relapsed and refractory multiple myeloma (RRMM) has achieved good efficacy, good safety and controllable adverse reactions
.
In terms of clinical management, Wuhan Xiehe first proposed CRS-related coagulation disorders, and Professor Mei Heng shared the clinical management experience of CAR-T therapy-related toxic and side effects through clinical trials
.
Drawing lessons from CAR-T international clinical application and management experience.
In this session, Dr.
Sattva S.
Neelapu from the University of Texas Anderson Cancer Medical Center shared a theme introduction entitled "Clinical application of CAR-T in DLBCL: International perspective"
.
Dr.
Sattva S.
Neelapu mainly introduced ZUMA-1 clinical research progress and case reports
.
Dr.
Sattva S.
Neelapu said that tumor burden is closely related to the efficacy and toxicity of CAR-T treatment.
With the increase of tumor burden, the ORR at one year does not change much, and the sustained remission rate gradually decreases.
The incidence of CRS and NEs of grade 3 or above It is the smallest when the tumor burden is low
.
The late toxicity after CD19 CAR-T cell treatment mainly includes late neurotoxicity such as temporary aphasia and seizures, hemophagocytic lymphohistiocytosis (HLH), grade 3 or above cytopenia, and B cell hypoplasia
.
Due to persistent B cell hypoplasia and T cell immune reconstitution data after fewer cell treatments, it is recommended that patients with HBV or HCV lymphoma continue long-term antiviral prophylaxis
.
In the discussion session of CAR-T treatment thinking collision, Professor Cui Guohui of the Union Hospital of Huazhong University of Science and Technology raised questions about the start time of CAR-T treatment in Case 1.
Dr.
Sattva S.
Neelapu said that the ZUMA-7 trial for second-line treatment of lymphoma (Axi -Cel) and TRANSFORM trials (Liso-Cel) showed favorable trends, while another BELINDA clinical trial (Tisa-Cel) for the second-line treatment of B-NHL did not reach the primary endpoint EFS, which means the phase 3 study failed
.
At present, the data is still immature and cannot be used as a second-line treatment for the time being.
In the future, based on the above-mentioned two beneficial clinical research results, CAR-T therapy is likely to be approved as a second-line treatment for relapsed and refractory lymphoma
.
Professor Mei Heng from Union Hospital of Huazhong University of Science and Technology raised questions about the efficacy of CAR-T as a second-line treatment.
Dr.
Sattva S.
Neelapu said that the structure and toxicity of Axi-Cel, Tisa-Cel and Liso-Cel are slightly different, and the remission rate is not high
.
Compared with Tisa-Cel, Axi-Cel has better clinical effects and shorter cell preparation time
.
The structure of Liso-Cel uses 4-1BB costimulatory molecules, which has good clinical safety and is milder than CD28 molecules
.
Professor Zhang Lu from Union Hospital of Huazhong University of Science and Technology raised questions about the first-line treatment of CAR-T.
Dr.
Sattva S.
Neelapu stated that patients showed clinical benefit and controllable safety in the ZUMA-12 clinical study of Axi-Cel first-line treatment of high-risk LBCL Compared with ZUMA-1, CAR-T cells in ZUMA-12 express higher CCR7 and have more undifferentiated phenotypes.
This is related to the expansion of CAR-T in vivo, indicating that CAR-T cells are in the earlier first-line Or the adaptability of second-line treatment is better
.
Summary At the end, Professor Mei Heng made a summary of the meeting
.
Professor Mei expressed his gratitude to Dr.
Sattva S.
Neelapu for his online report, and hoped to discuss the new CAR-T program at home and abroad to benefit more patients offline as soon as possible
.
The meeting ended successfully in the heated discussion of experts and scholars! Poke "read the original text", we make progress together
