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Revolutionizing Treatment: ASGCT’s Clinical Trials Spotlight on Immunotherapy, Cancer Vaccines, and Auditory Diseases

by Bernice Lottering
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At this year’s ASGCT‘s 27th Annual Meeting in Baltimore, groundbreaking clinical trials took center stage, illuminating the latest advancements in gene therapy research. These trials presented innovative approaches ranging from targeted cell and gene therapies to advancements in AAV gene therapy and novel findings in cell therapy. Here we dive deeper into immunotherapy and cancer vaccines, alongside novel treatments for auditory diseases. With a focus on cutting-edge treatments and promising outcomes, these presentations underscore the transformative potential of gene and cell therapy in addressing diverse medical challenges.

Immunotherapy and Cancer Vaccines

Generating Antitumor T Cells: Personalized Neoantigen Vaccine and Pembrolizumab in Advanced Hepatocellular Carcinoma

Customized cancer vaccines targeting neoantigens from a patient’s tumor may boost the effectiveness of PD-1 inhibitors by stimulating tumor-specific immune responses. Findings from a single-arm Phase Ib/2a study investigate the use of a personalized therapeutic cancer vaccine (PTCV), designed to target specific mutations in an individual’s tumor, in combination with pembrolizumab, a PD-1 inhibitor, for the treatment of advanced hepatocellular carcinoma (HCC). The results indicate that this combination therapy induces a robust immune response, involving both CD8+ and CD4+ T cells targeting tumor-specific neoantigens. These findings suggest a potential mechanism for the observed clinical activity and provide insight into improving treatment outcomes for patients with advanced HCC.

Long-Term Safety and Integration Site Analysis of T Cells Modified with Lentiviral or Gammaretroviral Gene Addition

No adverse events related to insertional mutagenesis were detected in a large patient cohort treated with CART therapy. Here, the long-term safety of CAR T cell therapy was assessed by analyzing data from 780 patients treated between 2001 and 2023. While 21 patients developed secondary malignancies, none were directly linked to the CAR T cell product. Integration site sequence analysis revealed insights into the behavior of transduced cell clones, with no evidence of pathogenic insertional mutagenesis. Overall, the study provides reassurance regarding the safety of CAR T cell therapy, despite recent concerns about secondary T cell malignancies.

Ophthalmic and Auditory Diseases

CHORD Trial: DB-OTO Gene Therapy for Pediatric Hearing Loss

This trial highlights the significance of biallelic otoferlin gene mutations in causing severe-to-profound sensorineural hearing loss, emphasizing the potential for OTOF gene replacement therapy to restore physiological hearing. Subsequently, this investigation introduces DB-OTO, a novel adeno-associated virus vector designed for intracochlear delivery of the OTOF gene, and outlines the objectives of the CHORD trial (NCT05788536) evaluating its safety and efficacy in pediatric patients with profound hearing loss due to OTOF mutations. Initial results from the trial demonstrate promising outcomes, with no dose-limiting toxicities or DB-OTO-related adverse events reported. Significant improvements in hearing, as indicated by behavioral pure tone audiogram thresholds and auditory brainstem response, were observed in the DB-OTO-treated ear. Additionally, parental reports and auditory skills assessments further support the positive impact of DB-OTO on auditory function and development. These findings underscore the potential of DB-OTO gene therapy as a viable treatment option for patients with profound hearing loss caused by OTOF mutations, warranting further investigation in larger patient cohorts.

In conclusion, the presentations from the ASGCT annual conference in Baltimore showcase significant strides in immunotherapy, gene therapy, and treatments for ophthalmic and auditory diseases. The studies on personalized neoantigen vaccines, CAR T cell therapy safety, and DB-OTO gene therapy offer promising insights into improving outcomes for patients with advanced hepatocellular carcinoma, hematologic malignancies, and hearing loss due to genetic mutations. These findings underscore the potential of innovative cell and gene therapies in addressing unmet medical needs and enhance patient care. Moving forward, continued research and development in these areas will be instrumental in advancing precision medicine and improving the lives of individuals affected by these conditions. ASGCT 2024, gene therapy, gene therapy definition, cell and gene therapy, AAV gene therapy, Cell Reports impact factor, cell therapy, American, Baltimore, therapy, cell

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