NUHS's CD7 CAR-T therapy promising for leukaemia

Singapore’s National University Health System (NUHS) has developed a promising new treatment for patients with relapsed or refractory T-cell acute lymphoblastic leukaemia (T-ALL). This innovative therapy involves modifying patients' T cells to carry an anti-CD7 chimeric antigen receptor (CAR), which is then re-administered to target leukaemia cells displaying the CD7 protein. This treatment was created through a collaboration between the National University of Singapore’s Yong Loo Lin School of Medicine (NUS Medicine) and the NUHS.

The therapy was administered to 17 patients at the National University Hospital (NUH) in Singapore and the Ospedale Pediatrico Bambino Gesù in Rome, Italy, from April 2019 to October 2023. These patients ranged in age from two to 72 years and had T-ALL that was either resistant to chemotherapy or had relapsed after treatment.

Utilizing advanced technology from Professor Dario Campana’s laboratory at NUS Medicine’s Department of Paediatrics, the therapy involved reprogramming the patients’ own T cells to express an anti-CD7 CAR. These re-engineered CAR T-cells specifically targeted and attacked T-leukaemia cells presenting the CD7 protein on their surface.

Remarkably, 16 out of the 17 treated patients achieved complete remission within one month, as confirmed by ultra-sensitive flow cytometry tests. These tests, developed by Elaine Coustan-Smith’s laboratory at NUS Medicine, were crucial in assessing CD7 expression in leukaemic cells to determine patient eligibility and monitor the CAR-T cells post-infusion.

One of the most notable successes of this therapy is the first patient treated, who has remained in remission for five years without requiring further chemotherapy or a bone marrow transplant. Despite the patients having high tumour burdens and extensive prior treatments, the therapy was well-tolerated with mild side effects.

Dr. Bernice Oh, a consultant in the Paediatric Haematology and Oncology Division at the National University Children’s Medical Institute (KTP-NUCMI) at NUH, and the study’s first author, expressed optimism about the new treatment. She emphasized that this CAR-T therapy provides a new and hopeful option for T-ALL patients who have exhausted conventional treatments. Dr. Oh noted that these patients had no remaining potentially curative options but could now have a clear chance at a cure with minimal severe side effects.

This development signifies a significant advancement in the treatment of T-ALL, particularly for patients with complex and treatment-resistant forms of the disease. The commitment to finding better cures for such challenging cancers continues to drive the researchers and medical professionals involved in this innovative therapy.

The exploration and progress in cell and gene therapy industries indicate a transformative potential in medical treatments, offering new avenues for curing diseases that were previously deemed intractable. This advancement is part of a broader trend in the medical field to harness the power of genetic and cellular modifications to provide more effective and targeted therapies. The success of the CD7 CAR-T cell therapy demonstrates the potential of these new treatment modalities to significantly improve patient outcomes and offer hope to those with limited options.