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https://www.nejm.org/doi/full/10.1056/NEJMc2403705 A new study showing scl70 can continue go down if cd19 car T cells sustained longer. Also chemo drug was given longer in this study. Just a Case study of course with limitations, maybe because spleen plasma cells are accountable for those...

Ah thank you. That's good to know. Is the Luminary BAFF including all three? Question: I was checking Novartis ELIANA trial and found out that FDA issued approval of Kymriah based on ELIANA, which is only a phase II with 88 patients. So does it mean we do not require Phase III for CAR T for SLE...

Thank you Dr. Edwards. I attached a figure from Dr. Schett's review. However, after reading your comments on ritux depleting plasmablasts, I realized the review figure could be misleading. According to this "static and fixed" view of marker expression, ritux will not touch plasmablasts, CD19 CAR...

Sorry I did not know that. Well, you are right- this does not look as miraculous. It might be similar to Tafasitamab. The only hope is to see if it depletes anti-drug antibodies. If so, it can still help many patients to restart their wonder biologics (TNFi).

The prerequisite for CD19 to give you relief is that the disease causing antibodies, at least part of which, are coming from plasmablasts. If they are only from LLPC, then there may not be any benefits. BAFF may not be a good target, if not paired with BCMA, I suspect. Well it is a little...

Thank you. It is a bad news to hear that maybe SSA is sufficient to trigger nephritis relapse. But at least we know which direction to work on. Hope that patient can go on for BCMA CAR T. So is myositis one. Yeah I agree, dual BCMA/CD19 will cover the full spectrum from pro-B to LLPC. It is also...

Rituximab does not target plasmablasts which probably account for the Anti-Smith. Given the disappearance of that by CD19 CAR T, I think it is not from LLPC.

Thank you for educating me on that. I agree. Some RA patients, especially seronegative ones, may not be responsive to CAR T if the pathology is not driven by autoantibodies.

This is definitely exciting and critical study to initiate the efforts to treat RA with deep depletion of B cells. However, one must be cautious interpreting the efficacy. The DAS28-CRP and RF/CCP level started to rise at 24 weeks. This is amid abatacept maintenance starting month 4. I wonder...

Dr. Thomas the lupus encyclopedia doctor heard one of Dr. Schett's patient's SLE relapsed (not verified)- have you heard anything about it?

May I ask are you sure 1 Schett's SLE patient's RA is treated well with CAR T CD19? I did not see it in his publication. Maybe I did not read it carefully enough?

Gracell is now part of AstraZeneca. Don't know how it is going to affect their strategy. For you, I think it remains a question how much your SSA is coming from plasma cells vs plasmablasts. And anti-smith is known to be likely from plasmablasts. I would suggest CD19 CAR T first if CD19-BCMA is...

Which report did you see? I saw there were 2 progressive MS patients received CAR T in March and it is too early to assess efficacy. Another question I have is how to know the duration of CAR T cells. Dr. Schett's adult patients received CAR T only last < 3months which is great for a reset. But...