CCR Live Program 2025

Update on CD19-Targeted CAR T-cell Therapy to Treat Severe Refractory Systemic Lupus Erythematosus (SLE)

a. The Classic dose-response where clinical effectiveness increases with dose is not always seen in lupus with immune modulating treatmentsb. Myeloid Cells are important in regulating B Cell survival and differentiation through secretion of BLys (BAFF)c. CAR T-cell therapy avoids the problems seen with Rituximab that may be caused by increased BLySd. Longterm drug-free remission for up to a year or more has occurred in some SLE patients receiving CAR T-cell therapy

a. Once the complex administrative process is completed, many patients may reduce or stop other immune modulating treatments and remain well for many months or moreb. It puts all patients with lupus into remission regardless of their individual pathologyc. There is no risk for neurologic side effects in SLEd. It is relatively inexpensive compared to the use of these agents in cancer

a. A high incidence of ICANS (Immune Cell Associated Neurotoxicity Syndrome)b. Delays in treatment due to the process needed to manufacture the cellsc. A high incidence of high-grade CRS (cytokine release syndrome)d. It is effective in only a small minority of patients

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Review the pathophysiology and mode of action of CAR T-cell therapy
Review the current clinical options, unmet needs, and emerging therapies for patients with severe, refractory systemic lupus erythematosus
Analyze the clinical trial data and clinical applications of CAR T-cell therapy to treat patients with severe, refractory SLE
Develop strategies to incorporate patient shared decision making when discussing CAR T-cell therapy for SLE

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Joan Merrill, MD

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