On April 13, 2026 BioOra Limited and Cincinnati Children’s reported a strategic partnership to advance Atla-cel, (atlacabtagene autoleucel, pINN List 134), a third-generation CD19-directed CAR-T cell therapy, into clinical development for children and adolescents with relapsed or refractory B-cell acute lymphoblastic leukaemia (B-ALL).

Schedule your 30 min Free 1stOncology Demo!
Discover why more than 1,500 members use 1stOncology™ to excel in:

Early/Late Stage Pipeline Development - Target Scouting - Clinical Biomarkers - Indication Selection & Expansion - BD&L Contacts - Conference Reports - Combinatorial Drug Settings - Companion Diagnostics - Drug Repositioning - First-in-class Analysis - Competitive Analysis - Deals & Licensing

                  Schedule Your 30 min Free Demo!

A differentiated safety profile — and what it means for children

Despite significant advances in frontline therapy, children with relapsed or refractory B-ALL face poor long-term outcomes and limited treatment options. First-generation approved CAR-T therapies have demonstrated meaningful efficacy. However, cytokine release syndrome (CRS) and, in particular, immune effector cell-associated neurotoxicity syndrome (ICANS), remain barriers to broader adoption, especially in paediatric patients, where neurotoxicity carries heightened developmental risks and typically requires intensive inpatient monitoring.

Atla-cel is a third-generation CD19-directed CAR-T therapy incorporating design advances intended to enhance anti-tumour activity and improve the tolerability profile compared with earlier-generation approaches. Results from the Phase 1 ENABLE-1 study in adults with relapsed or refractory lymphoma, presented at the 2024 American Society of Hematology (ASH) (Free ASH Whitepaper) Annual Meeting, demonstrated promising complete response rates alongside a safety profile notable for low rates of serious CRS and, critically, markedly reduced ICANS. These safety signals position Atla-cel as a compelling candidate for paediatric investigation.

In children, ICANS is not a side effect to be managed, it is an unacceptable risk. The developing brain is uniquely vulnerable to immune-mediated neurotoxicity, and this has kept CAR-T therapy from reaching many of the patients who need it most. The markedly low ICANS rates observed in adult studies provide the strongest rationale yet for paediatric evaluation and raise the prospect of outpatient delivery that would free children and families from the prolonged inpatient stays that currently approved therapies require.

The partnership with Cincinnati Children’s, one of the world’s leading paediatric academic medical centres with deep expertise in haematology, oncology, and cellular therapies, leverages clinical data from the ENABLE trial programme, conducted in collaboration between BioOra and the Malaghan Institute of Medical Research in New Zealand. Atla-cel incorporates design advances aimed at enhancing anti-tumour activity while improving tolerability compared with earlier-generation CAR-T therapies.

As part of the collaboration, Steve Davis, MD, President and Chief Executive Officer of Cincinnati Children’s, joins the BioOra Board of Directors.

Clinical programme: trial sites and leadership

The proposed paediatric B-ALL clinical programme would enrol patients across the United States, New Zealand, and potentially Australia, with trial management from Cincinnati Children’s.

The trial will be led by Stella M. Davies, MBBS, PhD, MRCP, Institute Co-Executive Director of the Cancer and Blood Diseases Institute and Director of the Division of Bone Marrow Transplantation and Immune Deficiency at Cincinnati Children’s, ranked the #1 cancer care provider in the United States by US News and World Report. Dr. Davies is a recognised leader in paediatric haematology-oncology and haematopoietic cell transplantation and currently serves as President-Elect of the American Society for Transplantation and Cellular Therapy.

Leadership perspectives

Laurence Cooper, MD, PhD, paediatric oncologist and Board Member of BioOra, said: "Children with relapsed B-ALL deserve effective, safer, and more accessible therapies. The ENABLE programme has given us confidence in Atla-cel’s adult safety profile; markedly reduced neurotoxicity is not a minor footnote in paediatric oncology, it is central to whether a therapy can safely be used in children. That is why this paediatric programme matters."

Stella M. Davies, MBBS, PhD, MRCP, Institute Co-Executive Director, Cancer and Blood Diseases Institute, Cincinnati Children’s, and Principal Investigator, said: "Relapsed B-ALL remains one of the toughest problems in childhood cancer. The low neurotoxicity signals from the ENABLE programme make Atla-cel a compelling candidate for paediatric investigation, and if that profile holds in children, it could mean bringing life changing CAR-T therapy to more kids."

John Robson, Chief Executive Officer of BioOra, said: "This collaboration reflects our conviction that next-generation CAR-T design, disciplined clinical execution, and automated manufacturing can together transform outcomes for children with ALL. Cincinnati Children’s brings the scientific depth, paediatric expertise, and global credibility this programme demands, and we are proud to partner with them."

Steve Davis, MD, President and Chief Executive Officer of Cincinnati Children’s, said: "Cincinnati Children’s is committed to delivering the safest and most advanced therapies to children with cancer. Atla-cel’s emerging safety profile, combined with BioOra’s manufacturing expertise and our shared clinical vision, creates a strong foundation to pursue a genuinely differentiated treatment option for children with relapsed B-ALL in the United States and globally."

(Press release, BioOra, APR 13, 2026, View Source [SID1234664332])