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Left to right: Saira Sheikh, MD; Jonathan S. Serody, MD; Natalie Grover, MD; Vimal Derebail, MD, MPH

The divisions of Rheumatology, Allergy & Immunology, Hematology and Nephrology & Hypertension are working together to bring new and innovative cell-based therapies to patients with systemic lupus erythematosus (SLE). This multidisciplinary, collaborative work brings further recognition to UNC as a leader in this space, and prominence as one of the few centers worldwide with expertise in this area. The emergence of Chimeric antigen receptor (CAR) T cell therapy, for indications beyond cancer, offers the promise for rapid and prolonged disease- and medication-free remission in patients with severe autoimmune disease, with potential for a cure.

In 2015, Drs. Gianpietro Dotti, Barbara Savoldo and Jonathan Serody initiated the UNC Cellular Therapy Program designed to bring adoptive cellular therapy using chimeric antigen receptors, which can bind to target with antibody affinity but with the function of T lymphocytes, to patients with cancer. Since that time, UNC has opened 18 clinical trials using CAR T cells to treat patients with hematological and solid tumors including therapy for patients with glioma, head and neck, lung, ovarian cancer, and triple negative breast cancer. This program composed of over 50 physicians, advanced practice professionals, clinical pharmacy practitioners, cellular therapy coordinators, financial counselors, study and data coordinators and regulatory staff, is currently the largest solid tumor cellular therapy program in the United States of America.

Additionally, investigators have found that CAR T cell targeting the B cell antigen CD19, used for the treatment of patients with B cell leukemia or lymphoma, can be deployed to treat autoimmune diseases. Under the leadership of Dr. Saira Sheikh in the Division of Rheumatology, Allergy & Immunology and the Thurston Arthritis Research Center, and co-led by Dr. Vimal Derebail in the Division of Nephrology and Hypertension and Dr. Natalie Grover in the Division of Hematology, the UNC Lupus Multidisciplinary Team has successfully treated several patients who have severe, refractory SLE with CAR T cells targeting the B cell antigen CD19. The initial data suggests the potential of this approach for an “immune system reset”, allowing patients to discontinue immunosuppressive therapies and achieve a compelling clinical response. The team is committed to providing an opportunity for patients across the state of North Carolina to participate in clinical trials for innovative treatments like CAR T at UNC.