Autolus Therapeutics, a UCL spinout, has secured FDA approval for its next-generation CAR-T cell therapy, obecabtagene autoleucel (obe-cel), now marketed as AUCATZYL. This personalized therapy is indicated for adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia (r/r B-ALL), marking a significant advancement in treating this aggressive blood cancer.
Clinical Efficacy and Trial Data
The FDA's approval was primarily based on the results of the Autolus FELIX clinical trial. The trial demonstrated that 63% of the 65 evaluable patients achieved overall complete remission, indicating the elimination of all signs of cancer in response to the treatment. Furthermore, 42% of patients achieved complete remission within three months, with a median duration of remission of 14.1 months.
Dr. Claire Roddie, lead investigator of the FELIX study and Associate Professor of Haematology at UCL Cancer Institute, emphasized the attractive risk-benefit profile of AUCATZYL, noting its high activity and manageable safety profile in B-ALL patients. She highlighted the therapy's long-term persistence and deep responses as critical factors for achieving long-term remissions in B-ALL.
Addressing Unmet Needs in R/R B-ALL
Approximately 8,400 new cases of ALL are diagnosed annually in the US and EU, with over 3,000 cases relapsing or not responding to standard treatments. Adult patients with r/r ALL face a poor prognosis, with a median overall survival of only eight months. AUCATZYL offers a crucial new treatment option for these patients, addressing a significant unmet medical need.
Mechanism of Action and Design
AUCATZYL is a CAR-T cell therapy that involves collecting a patient's own T-cells and genetically modifying them to target and destroy cancer cells. Specifically, the T-cells are engineered to express a CD19 chimeric antigen receptor (CAR) on their surface, enabling them to recognize and bind to cancerous B-cells expressing the CD19 protein.
Obe-cel was designed to overcome limitations associated with earlier CAR-T cell therapies, such as cytokine release syndrome and lack of T-cell persistence. These improvements aim to enhance the safety and efficacy of the therapy, leading to more durable remissions.
Manufacturing and Global Supply
AUCATZYL will be manufactured at Autolus' commercial manufacturing site in Stevenage, UK, ensuring a global supply of the therapy. Marketing authorization applications for obe-cel in adult r/r ALL are also under review by regulators in the EU and the UK, potentially expanding access to this innovative treatment.
Collaboration and Development
The development of obe-cel was a collaborative effort led by Dr. Martin Pule at UCL Cancer Institute, along with collaborators at the UCL Great Ormond Institute of Child Health. The clinical development in adult B-ALL was built on the ALLCAR19 clinical study, supported by grant funding from the NIHR. UCL Business (UCLB) played a crucial role in protecting and licensing the obe-cel technology, enabling Autolus to attract further capital for its development.
