Commercialization of TCR T-cell therapy: patient journey implications

T-cell receptors (TCRs) are the natural antigen recognition machinery of a T cell. Unlike the antibody recognition modality used in chimeric antigen receptors (CARs), TCRs recognize proteins that are expressed inside the cell, then broken down and presented on the cell surface in the context of the antigen presenting machinery called human leukocyte antigen (HLA). Because TCRs can access proteins expressed inside the cells of solid tumors, this allows access to a much broader range of potentially unique cancer targets. Adaptimmune engineers TCRs to specifically target intracellular proteins that are expressed in solid tumors. These TCRs are then put into a patient’s own T cells and given back to the patient to fight their cancer. Using this autologous cell therapy approach, Adaptimmune has multiple TCRs in clinical trials targeting a wide range of solid tumors. The commercialization of TCR T-cell therapies will be unique for a variety of reasons. Although we can learn from the currently marketed cell and gene therapies, cell therapy for solid tumors has its own set of specific challenges. Early commercial planning and cross-functional collaboration will be important components of successfully bringing these therapies to market. Here, we review three areas that impact the patient journey for TCR T-cell therapy including factors in patient identification and time to treatment, qualified treatment centers, and reimbursement implications specific to the US market.

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