Release date: 2024-08-12 10:22:16 Recommended: 203
On August 2, 2024, the FDA granted accelerated approval to afamitresgene autoleucel, marking the first gene-engineered T-cell therapy approved for the treatment of solid tumors. This therapy is specifically designed for adults with unresectable or metastatic synovial sarcoma, a rare and aggressive cancer with limited treatment options.
The approval was based on the positive outcomes of the phase 2 SPEARHEAD-1 trial, which evaluated the efficacy and safety of afamitresgene autoleucel in 52 patients with synovial sarcoma or myxoid round cell liposarcoma. These cancers account for 5-10% of all soft tissue sarcomas and typically have poor responses to existing second-line treatments.
All patients in the trial had tumors expressing the melanoma-associated antigen A4 (MAGE-A4) and were positive for specific HLA-A*02 alleles. The therapy involves genetically modifying a patient’s own T cells to target and destroy cancer cells expressing MAGE-A4.
The trial reported an overall response rate (ORR) of 37%, with a 39% response rate in patients with synovial sarcoma and 25% in those with myxoid round cell liposarcoma. The median duration of response was 6 months, and nearly half of the responding patients maintained their response for at least 6 months.
While hematological toxicities were common due to lymphodepletion chemotherapy, they were generally manageable. The most frequent adverse event was cytokine release syndrome, but most cases were mild and treatable.
The approval of afamitresgene autoleucel represents a significant advancement in personalized medicine, particularly for solid tumors. This therapy paves the way for further innovations in cancer treatment, offering new hope to patients with limited options.
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