July 28, 2021
Shet Biswas on the potential of cell therapy for sarcoma
July is Sarcoma Awareness Month. We mark this month, as we investigate one of our cell therapy products for people with synovial sarcoma and myxoid round cell liposarcoma (MRCLS). Based on the data from the SPEARHEAD-1 trial, that we reported at the annual ASCO 2021 meeting, we aim to file our first BLA next year for these indications.
This month’s perspective guest is Shet Biswas, a UK-accredited medical oncologist who is Senior Medical Director at Adaptimmune, and Project Leader the SPEARHEAD-1, clinical trial. We asked him a few questions about his background and his experience of treating patients with synovial sarcoma.
Tell us how you came to Adaptimmune
I came to Adaptimmune from GSK where I was doing Phase 1 and Phase 3 trials with an antibody drug conjugate (ADC) in multiple myeloma including combination therapies with checkpoint activating agonist antibodies (e.g., ICOS) and small molecules. Prior to that, for 18 years I was a National Health Service (NHS) doctor. During five of those years, I was an academic clinician (Senior Clinical Lecturer/Associate Professor), including being Principal Investigator on several Phase 1 trials, in which I treated too many patients with sarcoma, lymphoma, and glioblastoma.
Can you please tell us what are synovial sarcoma and MRCLS?
Synovial sarcoma is a rare cancer that usually affects young adults but can also affect children. The majority of patients with metastatic disease, both young and old, are treated with largely inefficacious chemotherapy. Unfortunately, treatment of metastatic synovial sarcoma has not seen the dramatic benefits from immunotherapy that more common cancers and melanoma have over the last decade. Tragically, the disease kills patients during what should be the prime of their lives. Myxoid/round cell liposarcoma, or MRCLS, is one of several types of liposarcoma. Liposarcoma grows in the cells that store fat in the body, usually grows in the arms and legs. These tumors grow slowly, and they can spread to other parts of the body. Each year in the United States, about 2,000 people are diagnosed with liposarcoma. MRCLS is one of the most common types of liposarcoma and makes up about 30% of all liposarcoma cases.1
What has been your experience of treating patients with synovial sarcoma?
Care of synovial sarcoma patients requires significant multi-disciplinary management involving oncologists, nurses, and social workers. Patients in the United Kingdom and increasingly so in North America are treated at specialist teenage and young adult (TYA) cancer centers. There are a limited number of these large patient volume TYA centers in the UK. I had the honor of working at one of these centers for 5 years as an NHS Consultant (Attending) where I divided my time equally between seeing TYA patients 16 years and older with a variety of primary/metastatic bone and soft-tissue sarcomas, as well as conducting laboratory research.
What is the potential of afami-cel for people with synovial sarcoma?
The challenges in treating young patients are multiple, but the potential approval of afami-cel by the FDA and EMA could lead to a paradigm shift in the treatment of advanced synovial sarcoma. It is not often in our careers that any of us will have the opportunity to work on a drug therapy that could potentially revolutionize how we treat a disease where current therapeutic options are very limited.
The ongoing afami-cel development program intends to treat both adults and children ≥ 10 years old with advanced synovial sarcoma, and we intend to seek regulatory approval in both the US and EU for as wide a synovial sarcoma patient population as possible.
1National Cancer Institute. Center for Cancer Research. Myxoid/Round Cell Liposarcoma. https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-soft-tissue-tumors/myxoid-round-cell-liposarcoma