CAR T-cell therapy is one of the emerging types of treatment for cancer, and CAR T-cell therapy for mesothelioma is gaining traction.
Another type of targeted therapy, an engineered T-cell receptor therapy, is moving through the clinical trial process for mesothelioma.
Gavocabtagene autoleucel, also called gavo-cel or TC-210, is a type of cancer cell and gene therapy developed by TCR2 Therapeutics. It’s designed for a few types of solid tumor cancers, including malignant mesothelioma, lung cancer and ovarian cancer. Gavo-cel is a T-cell receptor therapy that helps the immune system fight cancer.
The clinical trial is for pleural mesothelioma, peritoneal mesothelioma and a few other types of cancer. This blog outlines what gavo-cell is, how engineered T-cell receptor therapy works, and more information about the clinical trial.
What Is T-cell Receptor Therapy?
Gavo-cel is an engineered T-cell receptor (TCR) therapy, which is a type of cancer cell and gene therapy. Cancer cell and gene therapy falls within the class of cancer immunotherapy, but it’s different from immunotherapies like Keytruda and Opdivo.
For TCR therapy, doctors remove T cells from patients and add a laboratory-created receptor to the cells. This receptor helps the T cells, which are the main soldier cells of the immune system, identify cancer cells.
T cells are a white blood cell. Doctors extract T cells from the patient’s blood and send them to a laboratory for enhancement. The entire process can take a few weeks before the T cells receive their receptor and are returned to the patient.
Difference Between Engineered T-cell Receptors and CAR T-cell Therapy
Engineered T-cell receptor therapy is similar to CAR T-cell therapy. They’re both types of cell and gene therapy.
CAR T-cell therapy adds an engineered protein receptor to T cells that points the cells toward cancer cells expressing that protein. Recently, the FDA granted a CAR T-cell therapy with Orphan Drug Designation to help it progress through the clinical trial process.
The FDA approved six CAR T-cell therapies for blood cancers, including leukemia, lymphoma and myeloma. The FDA approved the first one, Kymriah, in 2017 for young leukemia patients.
TCR therapies, like gavo-cel, gain a protein receptor with a slightly different task. These receptors look for peptides, which are fragments of proteins released by cells. These fragments are brought to the surface of cells by the major histocompatibility complex (MHC). The MHC includes human leukocyte antigens (HLA), which is responsible for presenting these fragments to T cells.
If T cells have the engineered receptors that are associated with the peptides, then they’ll label the cells as cancerous.
There is only one engineered T-cell receptor therapy approved by the FDA for cancer. Kimmtrak was approved in 2022 for uveal melanoma, which is a rare skin cancer of the eye.
How Gavo-cel Helps People With Mesothelioma
Gavo-cel succeeded in a phase 1 trial. The disease control rate was 77%, meaning this percentage of patients either had their cancer stop growing or shrank thanks to the T-cell therapy. There were 30 patients in the phase 1 study, so 23 out of 30 patients had disease control.
The median overall survival for people with mesothelioma was 11 months. The progression-free survival was 5.6 months. For ovarian cancer, the overall survival was 8.1 months and the progression-free survival was 5.8 months.
Mesothelioma Clinical Trial for Engineered T-cell Receptor Therapy
The clinical trial is a phase 2 study for people with mesothelin-solid cancers. Mesothelioma cells often express mesothelin, a cancerous protein. Non-small-cell lung cancer and ovarian cancer also often expresses mesothelin.
Mesothelioma, lung cancer and ovarian cancer are all asbestos-related cancers. Mesothelioma’s only cause is asbestos, while the mineral is one of a few causes for lung cancer and ovarian cancer.
The phase 2 trial will consist of 75 patients with malignant mesothelioma. Another set will be included with each of the following cancers: ovarian, lung and cholangiocarcinoma. The trial has spots for up to 175 patients.
Adding Immunotherapy to the T-cell Receptor
In addition to the gavo-cel T-cell receptor therapy, mesothelioma patients will also receive one or multiple immunotherapy drugs. Half the patients will receive nivolumab (Opdivo) and the other half will receive nivolumab and ipilimumab (Yervoy). Opdivo and Yervoy are immune checkpoint inhibitor immunotherapies.
Doctors hope the combination of a T-cell enhancing therapy with immune checkpoint inhibitors will help T cells identify cancer cells in multiple ways.
Which Hospitals Are Hosting the T-cell Receptor Therapy Clinical Trial for Mesothelioma?
There are a handful of hospitals and cancer centers hosting this clinical trial. A few of them are on the list of the top mesothelioma cancer centers in the world.
The host sites are:
- University of California San Francisco Medical Center
- National Cancer Institute (Bethesda, Maryland)
- Memorial Sloan Kettering Cancer Center (New York)
- Penn Medicine Abramson Cancer Center (Philadelphia)
- University of Texas MD Anderson Cancer Center (Houston)
- Sarah Cannon Research Institute (Nashville, Tennessee)
- Princess Margaret Cancer Center (Toronto, Canada)
If you’d like to register for this clinical trial, contact our patient advocate team. Karen Ritter, RN, can help you reach out to these hospitals to ask about enrolling. If you have mesothelioma but do not qualify for this study, we can help find a similar clinical trial for you. Email Karen at email@example.com for help.
Sources & Author
- Gavo-cel Elicits Clinical Benefit in Solid Tumors, Including Ovarian Cancer and Mesothelioma. OncLive. Retrieved from: https://www.onclive.com/view/gavo-cel-elicits-clinical-benefit-in-solid-tumors-including-ovarian-cancer-and-mesothelioma. Accessed: 10/18/2022.
- Phase 1/2 Trial of Gavo-cel (TC-210) in Patients With Advanced Mesothelin-Expressing Cancer. Clinicaltrials.gov. Retrieved from: https://clinicaltrials.gov/ct2/show/NCT03907852. Accessed: 10/18/2022.
Sources & Author