Editor's Note: The 66th American Society of Hematology (ASH) Annual Meeting was held in San Diego, USA, from December 7–10, 2024. Renowned as the largest and most comprehensive international academic event in the field of hematology, the conference gathers leading experts and researchers worldwide to discuss and exchange groundbreaking advancements in hematology. At this year's meeting, the research led by Dr. Jing Pan from Beijing GoBroad Boren Hospital garnered significant attention, with two studies related to CAR-T therapy (abstracts 964 and 3466) being featured. To provide a deeper understanding of these pivotal findings, Hematology Frontier interviewed Dr. Jing Pan, who shared insights on these studies and the broader topic of CAR-T therapy. Below is a summary of the research and interview.

Abstract 964丨CD7 CAR-T-cell Therapy in Relapsed or Refractory T-cell Acute Lymphoblastic Leukemia-a Retrospective Study

Abstract 3466丨Safety and Feasibility of Intrathecal Infusion of CD19 and/or CD22 CAR-T Cells in r/r B-ALL Patients with CNSL or High-Risk CNS Relapse

Hematology Frontier: When CAR-T therapy was first introduced, it was positioned as a curative treatment. After years of development, do you think its role in treating hematologic malignancies has evolved?

Dr. Jing Pan: The role of CAR-T cell therapy in the treatment of hematologic malignancies has become increasingly solidified. In the early years, we witnessed a rapid and explosive growth of CAR-T products and clinical research, which significantly heightened awareness of this treatment. While the pace of advancements in the CAR-T field has since slowed, the recent ASH meeting showcased promising developments in basic and translational research related to CAR-T therapy, offering hope for the future.

Undoubtedly, CAR-T therapy has been positioned as a solution to some of the most challenging issues in the treatment of hematologic malignancies. Its significance and stability as a therapeutic option have grown over time. The advancement of CAR-T therapy depends on the synergistic integration of basic science, translational research, and clinical medicine.

Hematology Frontier: Your team has been making significant strides in the field of CD7 CAR-T therapy for T-cell malignancies. This year, one of your studies was featured at ASH. From the researcher’s perspective, what is the clinical value of this research?

Dr. Jing Pan: Indeed, at major international academic conferences such as ASH and EHA, our team primarily focuses on presenting the latest findings from our series of studies. At this year’s ASH meeting, we shared advancements in two main areas:

1. T-cell malignancies: We analyzed survival and prognostic factors in 75 patients with relapsed/refractory T-cell acute lymphoblastic leukemia (R/R T-ALL) who received CD7 CAR-T cell therapy.
2. B-cell malignancies: We explored the potential use of intrathecal CAR-T administration for patients with central nervous system (CNS) bulky masses or high CNS tumor burden. This approach aims to address some of the most challenging issues in hematologic oncology.

These studies underscore the evolving applications of CAR-T therapy in tackling highly refractory and complex hematologic malignancies.

Hematology Frontier: At this year’s ASH meeting, your team presented a study on intrathecal administration of CD19/CD22 CAR-T cells for patients with CNS leukemia (CNSL) or a high risk of CNS relapse in R/R B-ALL. How do you perceive the value of a stratified CAR-T treatment framework?

Dr. Jing Pan: The stratified treatment framework for B-cell acute lymphoblastic leukemia (B-ALL) using CAR-T therapy is becoming increasingly well-defined, with clearer stratification factors. This framework is based on nearly a decade of global CAR-T treatment data and practice. Studies presented at last year’s ASH and this year’s EHA meetings have demonstrated the clinical value of stratified CAR-T therapy.

In such a framework, identifying patients at high risk of relapse after CAR-T therapy and transitioning them to allogeneic hematopoietic stem cell transplantation (allo-HSCT) is critical. This approach significantly improves survival outcomes. Our center has long advocated for this stratified treatment concept. For certain B-ALL patients, CAR-T therapy alone can achieve a cure, while high-risk relapsing patients benefit from timely allo-HSCT. This framework has been consistently implemented at our center, and the related data have been published in Blood (Phase I study data from 2017–2018) and The Lancet Oncology (Phase II study data from 2019).

For CNS leukemia (CNSL) patients, who represent a small subset of relapsed B-ALL cases, we explored the use of intrathecal CAR-T administration. This study aimed to evaluate the safety and optimal timing of this approach. Our findings suggest that intrathecal CAR-T injection, administered after cytokine release syndrome (CRS) has subsided following systemic CAR-T infusion, is both safe and controllable. This strategy offers a promising therapeutic option for this particularly challenging subgroup of patients.

Hematology Frontier: What is your perspective on the future of CAR-T therapy in China?

Dr. Jing Pan: Some experts believe that China’s CAR-T clinical research is already among the global leaders. This is primarily due to several factors:

1. Extensive Clinical Experience: Chinese researchers have accumulated substantial clinical experience, supported by a large and diverse patient population, which provides a solid foundation for clinical trials.
2. Unique Trial Management System: The management framework for CAR-T clinical trials in China differs from that of other countries, offering certain advantages in trial implementation and progression.

However, it’s essential to recognize the challenges we face, particularly in basic research and translational medicine. Foundational research is crucial for fostering innovative thinking and identifying breakthrough directions, and in this area, we are relatively behind. Bridging this gap and integrating basic science with clinical research is a key step toward advancing China’s position in the global CAR-T landscape. We are optimistic about catching up and enhancing our contributions to the field.

About Dr. Jing Pan

Position:

• Director, Department of Hematologic Oncology and Immunotherapy, Beijing GoBroad Boren Hospital
• Master’s Supervisor, China Pharmaceutical University

• Member, Pediatric Oncology Committee, Chinese Anti-Cancer Association
• Youth Committee Member, Hematologic Oncology Committee, Chinese Anti-Cancer Association
• Member, Synthetic Biotechnology Subcommittee, Chinese Medical Biotechnology Association
• Member, Clinical Application Committee, Chinese Medical Biotechnology Association
• Advisor, Cellular Immunotherapy Group, Pediatric Hematology-Oncology Committee, Guangdong Clinical Medicine Association
• Expert, Beijing Medical and Health Technology Innovation Transformation Expert Database

Research Focus: Professor Pan specializes in immunotherapy and cellular therapy for hematologic malignancies, particularly CAR-T therapy, with a focus on innovative applications and addressing challenges in treating high-risk patient populations.