
Immunofluorescence staining of human mesothelioma showing tumor cells (green) and T cells (red).
Chimeric antigen receptor (CAR) T cell therapy has shown great promise for the treatment of certain blood cancers, like leukemia and lymphoma. By contrast, using this method to treat solid tumors has been more challenging.
On March 31, 2019, Memorial Sloan Kettering researchers presented results from a phase I clinical trial of CAR therapy in mesothelioma. This hard-to-treat cancer usually affects the tissue surrounding the lungs, called the pleura.
According to Prasad Adusumilli, a physician-scientist at MSK who is leading the trial, the CAR therapy proved safe and showed signs of efficacy in a small number of patients. Dr. Adusumilli presented these results at the annual meeting of the American Association for Cancer Research, held this year in Atlanta. The study was featured in the meeting’s press program.
“Traditionally, these patients with advanced-stage solid tumors have had poor outcomes despite aggressive treatment,” Dr. Adusumilli says. “These results are encouraging for patients who have limited treatment options.”
Study Details

Physician-scientist Prasad Adusumilli (center) with research fellows Zachory Tano (left) and Xiaoyu Li (right)
This trial included 21 patients: 19 with pleural mesothelioma, one with metastatic lung cancer, and one with metastatic breast cancer. They received CAR T cells built to target a molecule called mesothelin found on the surface of the cancer cells. The CAR T cells were infused directly into the space between the pleura.
A few weeks after the CAR T infusion, 14 patients received another immunotherapy treatment called pembrolizumab (Keytruda®). This drug, a type of checkpoint inhibitor, blocks a molecule on immune cells called PD-1 and boosts immune responses. Dr. Adusumilli and colleagues had previously shown that this combination was effective in treating cancer in mice.
Two patients who received PD-1-blocking drug had a complete response, as measured on PET scans, at 38 and 60 weeks after treatment. Five patients had a partial response, and four had stable disease.
Patients tolerated the CAR T treatment well. There were no CAR T–related side effects. Severe cytokine release syndrome, which is characterized by dangerously high fevers and has complicated CAR therapy for other cancers, did not occur in any of the patients.
“The combination of CAR T cell plus checkpoint blockade has been long awaited,” says Michel Sadelain, one of the pioneers of CAR T therapy. “This is the first study to support its possible efficacy in solid tumors.” The study represents 10 years of effort at MSK to develop a CAR therapy for solid tumors, he adds.
Back to topExpanding the CAR Fleet
MSK scientists developed the first effective CAR T cells for cancer. These prototype cells are built with an activity-boosting molecule called CD28 and target a molecule on B-cell leukemia and lymphoma called CD19. This cell-surface molecule is a good target for CARs because it is found on all B-cell cancers but not on other tissues that are critical for life.
Mesothelin is a potentially good target for CARs because it is present abundantly on solid tumor cancer cells but minimally on normal tissues. In addition to mesothelioma, mesothelin is found on pancreatic cancer, triple-negative breast cancer, lung cancer, and others. Drs. Adusumilli and Sadelain designed the mesothelin-specific CARs used in this study. The CAR T cells used in this study were engineered in MSK’s cell manufacturing facility, led by Isabelle Rivière.
“We are encouraged by these results,” Dr. Adusumilli says. “We hope they spur interest in the potential of CAR T cell therapy for solid tumors.”
Editor’s note: An earlier version of this article was published on May 17, 2018. It was updated with new information on March 31, 2019.
Back to topComments
Richard Carlstrand
May 29, 2018 • 12:44 PM
M. Fraser Hunter
Dec 1, 2018 • 12:43 PM
Memorial Sloan Kettering
Dec 3, 2018 • 11:14 AM
In reply to Hello, I am curious to know… by M. Fraser Hunter
Dear Fraser, according to Dr. Adusumilli, mesothelin can be found in both HER2-positive and HER2-negative tumors. It is only found in a proportion of patients for both types, and a higher percentage of HER2-negative patients have it. The only way doctors can determine mesothelin status in a given patient is by testing the tumor. For HER2-positive patients, the CAR T cell trial is not available because there are better therapy options. Thank you for your comment.
M. Snyder
Dec 15, 2018 • 5:33 AM
Memorial Sloan Kettering
Dec 16, 2018 • 3:28 PM
In reply to Is this trial an option for… by M. Snyder
MSK has a number of trials for metastatic lung cancer. If you would like to make an appointment to learn more, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information. Thank you for your comment and best wishes to you.
How About Prostate Cancer Patients
Mar 31, 2019 • 6:10 PM
Memorial Sloan Kettering
Apr 1, 2019 • 10:03 AM
In reply to Can it work on prostate… by How about prostate cancer patients
Yasmin
Apr 4, 2019 • 2:29 PM
Dear Yasmin, we’re sorry to hear about your diagnosis. There are no FDA-approved CAR T treatments for breast cancer, but MSK does have a clinical trial for certain subtypes of metastatic breast cancer. If you are interested in learning more, or finding out about what other treatments MSK has available, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.
Andrea Dow-Potts
Apr 23, 2019 • 5:00 PM
Memorial Sloan Kettering
Apr 24, 2019 • 9:31 AM
In reply to Is there any research using… by Andrea Dow-Potts
Rob Watson
Apr 23, 2019 • 6:04 PM
Marlene Kluger
Jun 18, 2019 • 1:16 PM
Memorial Sloan Kettering
Jun 18, 2019 • 3:15 PM
In reply to Anything new for Metastatic… by Marlene Kluger
Dear Marlene, to learn about MSK’s approach to treating liver metastases, you can go to this page. We also have a number of clinical trials.
If you or someone you know is interested in arranging a consultation to learn more, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.
Melissa
Jul 8, 2019 • 5:33 PM
Dear Melissa, we do not have any CAR T trials for gastric cancer, but we do have many other trials, including some that look at immunotherapy with checkpoint inhibitor drugs. If you or someone you know is interested in arranging a consultation to learn more, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.
Jamel
Jul 18, 2019 • 4:43 AM
Dear Jamel, to learn about treatment options, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.
Francesca
Aug 25, 2019 • 9:37 PM
Memorial Sloan Kettering
Aug 26, 2019 • 10:27 AM
In reply to Is there any CAR T treatment… by Francesca
Dear Francesca, we currently have two clinical trials looking at CAR T therapy for breast cancer. If you or someone you know is interested in learning more, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.
JM
Sep 11, 2019 • 6:56 PM
If you would like to arrange a consultation to find out if you are eligible for any trials, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.
Thank you