Using Immune Profiling to Better Understand CAR-T Cell Response | Theresia Akhlaghi, MD | ASCO YIA

My name is Theresa Aklagy and I'm a hematology oncology fellow at Wild Cornell focusing on multiple myeloma. I wanted to tell you a little bit about my research project who recently got a young investigator grant from the American Society of Clinical Oncology and this is focusing on CAR T cell therapy for multiple myeloma patients. So CAR T cell therapy is transforming the treatment for relapsed multiple myeloma and we're seeing some unprecedented responses in situations where the prognosis was previously poor. However, there's still a subset of patients that don't respond to these therapies or whose responses are short-lived. So we are trying to identify the key immune factors that drive response and toxicity to CAR T cell therapy in multiple myeloma. To do this, we're collecting blood samples from myeloma patients throughout their CAR T journey starting at collecting collection for the CAR T cells and then the product itself followed by several time points after the CAR T cell infusion. We will then perform comprehensive analysis of these samples to elucidate the makeup of the immune cells, the type of cells that are there, the states that they're in and our goal is to identify the cell types and states that drive response, relapse and toxicity. The immune system of multiple myeloma patients is often exhausted both due to the disease itself but also due to the several lines of treatment that these patients often have been on going into CAR T cell therapy. We believe that immune exhaustion is a key contributor to relapse of CAR T cell therapy in myeloma and CAR T cell therapy is an intensive treatment. It can be logistically and financially challenging and it also has some significant toxicities. So we hope to, by improving our understanding of the immune dynamics and how this contributes to response, we will provide tools to identify the patients that are the optimal candidates for this therapy based on their immune system, both the type of cells that they have but also the fitness of those cells. And also by identifying markers that predict relapse after CAR T treatment, we hope to be able to identify high-risk patients early and thereby tailor the post-CAR T treatment in order to prevent relapse. So we hope that the findings of this project will ultimately lead to improved outcomes of CAR T cell therapy in myeloma and I wanted to thank Cindy Szymlewska as well who's been supporting this project and the capacity of a patient advocate.