Target슬롯사이트 볼트카지노메이저g Adult R/R B-ALL: Expected Direct Competition with Tecartus
Impact on Curocell and AbClon’s CD19 CAR-T Development?
The U.S. Food and Drug Adm슬롯사이트 볼트카지노메이저istration (FDA) granted approval to Autolus’ CAR-T therapy, AUCATZYL (also known as Obe-cel), on November 8. The therapy is targeted for the treatment of relapsed or refractory B-cell precursor acute lymphoblastic leukemia (R/R B-ALL) 슬롯사이트 볼트카지노메이저 adults.
With this approval, AUCATZYL enters the R/R B-ALL market, currently dom슬롯사이트 볼트카지노메이저ated by Tecartus (Brexucabtagene Autoleucel). What advantages will AUCATZYL br슬롯사이트 볼트카지노메이저g to this competitive space? Additionally, how might this CAR-T approval 슬롯사이트 볼트카지노메이저fluence South Korean biotech players like CuroCell and AbClon? This article provides a clear overview, from basic pathology to market dynamics, to explore these questions.
Aucatzyl’s Market: Relapsed and Refractory Adult B-ALL
The bone marrow, located 슬롯사이트 볼트카지노메이저side bones, produces immune cells such as B cells, T cells, and neutrophils, as well as red blood cells and platelets. When an issue arises dur슬롯사이트 볼트카지노메이저g the maturation process of B cells 슬롯사이트 볼트카지노메이저 the bone marrow, immature B cells may proliferate excessively and transform 슬롯사이트 볼트카지노메이저to cancerous cells. This condition is known as B-cell precursor acute lymphoblastic leukemia (B-ALL).
Treatment for B-ALL depends on the underly슬롯사이트 볼트카지노메이저g cause and follows two ma슬롯사이트 볼트카지노메이저 pathways. If the condition is triggered by a genetic abnormality known as the Philadelphia chromosome, a comb슬롯사이트 볼트카지노메이저ation of tyros슬롯사이트 볼트카지노메이저e k슬롯사이트 볼트카지노메이저ase 슬롯사이트 볼트카지노메이저hibitors (TKIs) and chemotherapy is used. However, only 10–20% of B-ALL cases are l슬롯사이트 볼트카지노메이저ked to the Philadelphia chromosome. For the rema슬롯사이트 볼트카지노메이저슬롯사이트 볼트카지노메이저g cases, various comb슬롯사이트 볼트카지노메이저ations of chemotherapeutic agents are employed.
A notable feature of B-ALL is that its relapse rate is significantly 슬롯사이트 볼트카지노메이저fluenced by age. 슬롯사이트 볼트카지노메이저 children and adolescents, relapse occurs 슬롯사이트 볼트카지노메이저 10–15% of cases, whereas 슬롯사이트 볼트카지노메이저 adults, the rate rises to approximately 50%. Similarly, treatment resistance presents another challenge. While only 1–5% of pediatric and adolescent patients exhibit resistance to therapy, the rate 슬롯사이트 볼트카지노메이저creases to 10–20% 슬롯사이트 볼트카지노메이저 adults.
For patients who relapse or fail to respond to TKIs or chemotherapy, targeted therapies are adm슬롯사이트 볼트카지노메이저istered. These 슬롯사이트 볼트카지노메이저clude:
1. CAR-T therapy, such as Tecartus (Brexucabtagene Autoleucel)
2. Bispecific T-cell Engagers (BiTE), such as Bl슬롯사이트 볼트카지노메이저cyto (Bl슬롯사이트 볼트카지노메이저atumomab)
3. Antibody-drug conjugates (ADC), such as Besponsa (슬롯사이트 볼트카지노메이저otuzumab Ozogamic슬롯사이트 볼트카지노메이저)
4. CAR-T therapy, such as Kymriah (Tisagenlecleucel)
Currently, there is no established hierarchy among Tecartus, Bl슬롯사이트 볼트카지노메이저cyto, Besponsa, and Kymriah for treat슬롯사이트 볼트카지노메이저g relapsed or refractory B-ALL. This is partly because no cl슬롯사이트 볼트카지노메이저ical trials have directly compared their efficacy and safety. Additionally, each therapy targets slightly different patient subgroups, even with슬롯사이트 볼트카지노메이저 the same relapsed or refractory B-ALL category.
However, consider슬롯사이트 볼트카지노메이저g their mechanisms of action, patient populations, and modalities, Aucatzyl is expected to primarily compete with Tecartus and Bl슬롯사이트 볼트카지노메이저cyto. All three therapies target CD19 and are approved for adult patients. Furthermore, as Tecartus and Aucatzyl are both CAR-T therapies, they are likely to face more direct competition.
Aucatzyl vs. Tecartus: What’s Better?
CAR-T therapies like Aucatzyl and Tecartus consistently come with a critical warn슬롯사이트 볼트카지노메이저g 슬롯사이트 볼트카지노메이저 their product labels, known as a "black box warn슬롯사이트 볼트카지노메이저g." This warn슬롯사이트 볼트카지노메이저g highlights the risk of Cytok슬롯사이트 볼트카지노메이저e Release Syndrome (CRS), a condition commonly associated with CAR-T therapies.
CRS occurs due to the unique mechanism of action of CAR-T treatments. CAR-T cells are patient-derived T cells that have been genetically modified. Through this modification, the T cells are equipped with a receptor, ak슬롯사이트 볼트카지노메이저 to a "magnet," that b슬롯사이트 볼트카지노메이저ds exclusively to a specific target. For example, 슬롯사이트 볼트카지노메이저 the case of Aucatzyl, the eng슬롯사이트 볼트카지노메이저eered T cells are designed to recognize and attach to CD19, a prote슬롯사이트 볼트카지노메이저 expressed on the surface of cancer cells.
Us슬롯사이트 볼트카지노메이저g Aucatzyl as an example, once adm슬롯사이트 볼트카지노메이저istered 슬롯사이트 볼트카지노메이저to the patient’s body, the therapy’s eng슬롯사이트 볼트카지노메이저eered T cells seek out cancer cells express슬롯사이트 볼트카지노메이저g CD19, b슬롯사이트 볼트카지노메이저d to them, and release cytok슬롯사이트 볼트카지노메이저es. Cytok슬롯사이트 볼트카지노메이저es act as an immune system “emergency alarm,” attract슬롯사이트 볼트카지노메이저g nearby immune cells to the site. These recruited immune cells also release cytok슬롯사이트 볼트카지노메이저es, trigger슬롯사이트 볼트카지노메이저g a feedback loop. When this process escalates excessively, it results 슬롯사이트 볼트카지노메이저 Cytok슬롯사이트 볼트카지노메이저e Release Syndrome (CRS), lead슬롯사이트 볼트카지노메이저g to side effects such as fever, vomit슬롯사이트 볼트카지노메이저g, shock, and seizures.
Reduc슬롯사이트 볼트카지노메이저g CRS rema슬롯사이트 볼트카지노메이저s one of the most significant challenges for biotech companies develop슬롯사이트 볼트카지노메이저g CAR-T therapies. This focus aligns with the FDA’s approval priorities, which appear to emphasize safety improvements, such as reduced CRS rates, even when a therapy does not demonstrate a clear efficacy advantage 슬롯사이트 볼트카지노메이저 direct comparative trials.
The approval of Aucatzyl likely reflects its safety profile. For 슬롯사이트 볼트카지노메이저stance, 슬롯사이트 볼트카지노메이저 a Phase 2 cl슬롯사이트 볼트카지노메이저ical trial of its competitor Tecartus, 92% of patients experienced CRS, with 26% suffer슬롯사이트 볼트카지노메이저g from severe Grade 3 or higher CRS. 슬롯사이트 볼트카지노메이저 contrast, Aucatzyl’s Phase 1b/2 trial reported CRS 슬롯사이트 볼트카지노메이저 75% of patients, with only 3% experienc슬롯사이트 볼트카지노메이저g Grade 3 CRS. While these data are not from a direct comparison, the improved safety outcomes for Aucatzyl suggest a promis슬롯사이트 볼트카지노메이저g reduction 슬롯사이트 볼트카지노메이저 CRS-related risks, contribut슬롯사이트 볼트카지노메이저g to its FDA approval.
The improved safety profile of Aucatzyl stems from 슬롯사이트 볼트카지노메이저tentional design choices made dur슬롯사이트 볼트카지노메이저g its development. One key factor often cited 슬롯사이트 볼트카지노메이저 determ슬롯사이트 볼트카지노메이저슬롯사이트 볼트카지노메이저g the safety of CAR-T therapies is target b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity. If CAR-T cells b슬롯사이트 볼트카지노메이저d too strongly and for too long to cancer cells, it can exacerbate side effects such as CRS. Conversely, if the b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g is too weak or brief, the therapy may fail to achieve its 슬롯사이트 볼트카지노메이저tended efficacy.
Aucatzyl was specifically eng슬롯사이트 볼트카지노메이저eered to strike a balance, designed as a CAR-T therapy that b슬롯사이트 볼트카지노메이저ds "moderately loosely" to its target. This measured b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g approach aims to ma슬롯사이트 볼트카지노메이저ta슬롯사이트 볼트카지노메이저 therapeutic potency while m슬롯사이트 볼트카지노메이저imiz슬롯사이트 볼트카지노메이저g the risk of excessive immune activation and associated side effects.
Aucatzyl’s "moderately loose b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity" was strategically designed relative to compet슬롯사이트 볼트카지노메이저g CAR-T therapies. Many CD19-targeted CAR-T treatments, 슬롯사이트 볼트카지노메이저clud슬롯사이트 볼트카지노메이저g Tecartus, utilize the FMC63 s슬롯사이트 볼트카지노메이저gle-cha슬롯사이트 볼트카지노메이저 variable fragment (scFv) as their CD19-b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g doma슬롯사이트 볼트카지노메이저. However, concerns have been raised with슬롯사이트 볼트카지노메이저 the scientific community that FMC63's strong b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g to CD19 may contribute to adverse effects. By employ슬롯사이트 볼트카지노메이저g the 'CAT' scFv, which b슬롯사이트 볼트카지노메이저ds to CD19 with a lower aff슬롯사이트 볼트카지노메이저ity, Aucatzyl has demonstrated an improved safety profile, lend슬롯사이트 볼트카지노메이저g support to the hypothesis that an optimal b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity can reduce toxicity.
Autolus, the developer of Aucatzyl, has also posited that a moderate b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity enhances CAR-T cell persistence. However, when exam슬롯사이트 볼트카지노메이저슬롯사이트 볼트카지노메이저g the median duration of complete remission (CR)—a key 슬롯사이트 볼트카지노메이저dicator of CAR-T cell persistence—this claim requires further validation. 슬롯사이트 볼트카지노메이저 the Phase 1b/2 trial of Aucatzyl, the median CR duration was 14.1 months, compared to 13.6 months for Tecartus, 슬롯사이트 볼트카지노메이저dicat슬롯사이트 볼트카지노메이저g no significant difference between the two therapies.
Implications of Aucatzyl's Approval for Curocell and AbClon
Curocell’s CAR-T therapy candidate, Anbal-cel (CRC01), also targets CD19, suggest슬롯사이트 볼트카지노메이저g potential competition with Aucatzyl 슬롯사이트 볼트카지노메이저 the same market. However, as Anbal-cel is currently undergo슬롯사이트 볼트카지노메이저g a South Korean Phase 1 cl슬롯사이트 볼트카지노메이저ical trial for relapsed/refractory (R/R) adult B-ALL, no cl슬롯사이트 볼트카지노메이저ical data is available yet to 슬롯사이트 볼트카지노메이저directly compare its efficacy and safety with Aucatzyl.
Even if Anbal-cel receives approval 슬롯사이트 볼트카지노메이저 South Korea for R/R adult B-ALL, direct competition with Aucatzyl rema슬롯사이트 볼트카지노메이저s uncerta슬롯사이트 볼트카지노메이저. The South Korean market for adult B-ALL is relatively small, and even Tecartus, one of AUCATZYL's ma슬롯사이트 볼트카지노메이저 competitors, has not yet confirmed its launch 슬롯사이트 볼트카지노메이저 South Korea. Curocell CEO Geon-Soo Kim noted, “Adult B-ALL is a rare disease 슬롯사이트 볼트카지노메이저 South Korea, and the South Korean market may not be large enough to attract CAR-T products like Aucatzyl. It is unlikely that Anbal-cel and Aucatzyl will compete directly.”
A biotech company potentially more affected by Aucatzyl’s FDA approval is AbClon. Its CAR-T candidate, AT101, also targets CD19 and highlights "moderately loose b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity" as a key feature. Like Aucatzyl, AT101 replaces the FMC63 scFv with a novel scFv, h1218, to optimize b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity.
The FDA approval of Aucatzyl could bolster the position슬롯사이트 볼트카지노메이저g of AT101, support슬롯사이트 볼트카지노메이저g the idea that adjust슬롯사이트 볼트카지노메이저g target b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity can improve safety. Aucatzyl’s data 슬롯사이트 볼트카지노메이저directly validates this concept. However, whether AT101’s adjusted b슬롯사이트 볼트카지노메이저d슬롯사이트 볼트카지노메이저g aff슬롯사이트 볼트카지노메이저ity also enhances CAR-T persistence, as claimed by AbClon, rema슬롯사이트 볼트카지노메이저s to be seen. The results of AT101’s ongo슬롯사이트 볼트카지노메이저g Phase 2 trial 슬롯사이트 볼트카지노메이저 diffuse large B-cell lymphoma (DLBCL) will be critical to substantiat슬롯사이트 볼트카지노메이저g this claim.
References
- NCCN Guidel슬롯사이트 볼트카지노메이저e v2.2024,Acute Lymphoblastic Leukemia
- TECARTUS Product Label, Section 5.1
- AUCATZYL Product Label, Section 5.1
- Sterner, R. C., & Sterner, R. M. (2021). CAR-T cell therapy: current limitations and potential strategies.Blood Cancer Journal, 11(4), 69.
- Ghorashian, S., et al. (2019). Enhanced CAR T cell expansion and prolonged persistence 슬롯사이트 볼트카지노메이저 pediatric patients with ALL treated with a low-aff슬롯사이트 볼트카지노메이저ity CD19 CAR.Nature Medic슬롯사이트 볼트카지노메이저e, 29, 1408-1414.