Metastatic synovial sarcoma is a rare tumor—and a deadly one. In 2018, only 587 cases were reported in the US, the majority of which affected young men. At the time, surgery followed by radiotherapy and/or chemotherapy were the only treatments—all of which would fail sooner than later. The future was bleak for these patients.

Margaret von Mehren, MD, Chief, Division of Sarcoma Medical Oncology at Fox Chase Cancer Center, always held out hope. “I’ve watched with great interest as clinical trials for metastatic synovial sarcoma have evolved using a first-ever gene therapy for solid tumors that showed benefits,” says von Mehren. The therapy, afamitresgene autoleucel or TECELRA®, is a T cell receptor for patients with unresectable or metastatic synovial sarcoma who have received prior chemotherapy, present with certain HLA antigens, and have a MAGE-A4 antigen tumor expression.

Understanding the long lead time from clinical trial to actual patient administration, von Mehren jumped on the opportunity and partnered with colleagues from Fox Chase, Temple Health, and Adaptimmune, the manufacturer of afamitresgene autoleucel, to build the complex screening, testing, and therapeutic infrastructure to offer this cellular therapy so that once it received FDA approval, Fox Chase could offer it to patients. “Timing is critical for individuals with metastatic synovial sarcoma. Consulting with a center like Fox Chase earlier on—well before traditional therapies fail—ensures that a patient doesn’t lose time segueing to a treatment that can be a life-extender.”

“Our ability to administer afamitresgene autoleucel is predicated on a strong collaboration between the Fox Chase Sarcoma team and Fox Chase – Temple Bone Marrow Transplant and Cellular Therapy Programs. Although afamitresgene autoleucel is one of the first gene therapies for solid tumors, our group has decades of experience administering similar therapies for lymphoma and leukemia. This experience is highly translatable when it comes to managing side effects such as cytokine release syndrome and neurotoxicity and the general care required for these vulnerable patients. This is a level of quaternary care that only a cancer-centric hospital such as Fox Chase can offer,” says von Mehren.