The approval of CD19-directed chimeric antigen receptor (CAR) T-cell therapies for the second-line treatment of high-risk large B-cell lymphoma (LBCL) has greatly affected salvage algorithms for this condition, and such therapies could have the potential to improve the course of relapsed or refractory LBCL. In this Review, we provide guidance for a rational management approach to the use of commercial CD19-directed CAR T cells in the second-line treatment of LBCL, addressing crucial questions regarding eligible histologies; age, comorbidity, and tumour biology restrictions; the handling of very aggressive tumour behaviour; and holding and bridging therapies. The guidance was developed in a structured manner and, for each question, consists of a description of the clinical issue, a summary of the evidence, the rationale for a practical management approach, and recommendations. These recommendations could help to decide on the optimal management of patients with relapsed or refractory LBCL who are considered for second-line CAR T-cell treatment.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/S2352-3026(23)00307-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
CAR-based cell therapies for systemic lupus erythematosus.
Chin Med J (Engl)
December 2024
Department of Rheumatology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai 200127, China.
The remarkable efficacy of chimeric antigen receptor (CAR) T cell therapy in hematological malignancies has provided a solid basis for the therapeutic concept, wherein specific pathogenic cell populations can be eradicated by means of targeted recognition. During the past few years, CAR-based cell therapies have been extensively investigated in preclinical and clinical research across various non-tumor diseases, with particular emphasis in the treatment of autoimmune diseases (ADs), yielding significant advancements. The recent deployment of CD19-directed CAR T cells has induced long-lasting, drug-free remission in patients with systemic lupus erythematosus (SLE) and other systemic AD, alongside a more profound immune reconstruction of B cell repertoire compared with conventional immunosuppressive agents and B cell-targeting biologics.
View Article and Find Full Text PDFLisocabtagene Maraleucel for Relapsed/Refractory Large B-Cell Lymphoma: A Cell Therapy Consortium Real-World Analysis.
Blood Adv
December 2024
University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Lisocabtagene maraleucel (liso-cel) is an autologous CD19-directed CAR T cell therapy approved for the treatment of relapsed/refractory large B-cell lymphoma (LBCL). We present a multicenter retrospective study evaluating safety, efficacy, and resource utilization of liso-cel in the standard-of-care setting. Patients received commercial liso-cel at 7 US medical centers and patient selection, toxicity management, and disease assessment followed institutional practices.
View Article and Find Full Text PDFAdvances in CD19-targeting CAR-T cell therapies for multiple myeloma.
Expert Opin Biol Ther
December 2024
Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany.
Introduction: Emerging evidence suggests that, while CD19 is primarily expressed on immature B-cell precursors, it is also present on drug-resistant plasma cells that have been postulated to function as multiple myeloma (MM) stem cells, driving the progression of relapsing disease. Targeting CD19 with chimeric antigen receptor (CAR) T cells offers a promising strategy for addressing this residual disease burden, potentially leading to more durable treatments and enhanced relapse prevention.
Areas Covered: This review examines the molecular basis of CD19-targeted CAR-T therapy in MM, highlighting its potential, key challenges, and efficacy and safety in early clinical trials for relapsed/refractory and newly diagnosed MM.
Radiomic features of PET/CT imaging of large B cell lymphoma lesions predicts CAR T cell therapy efficacy.
Front Oncol
November 2024
Blood and Marrow Transplant, H. Lee. Moffitt Cancer Center, Tampa, FL, United States.
Background: Relapsed and refractory Diffuse large B cell lymphoma (DLBCL) can be successfully treated with axicabtagene ciloleucel (axi-cel), a CD19-directed autologous chimeric antigen receptor T cell (CAR-T) therapy. Diagnostic image-based features could help identify the patients who would clinically respond to this advanced immunotherapy.
Purpose: The aim of this study was to establish a radiomic image feature-based signature derived from positron emission tomography/computed tomography (PET/CT), including metabolic tumor burden, which can predict a durable response to CAR-T therapy in refractory/relapsed DLBCL.
Dual targeting CAR-T cells for B-cell acute lymphoblastic leukaemia and B-cell non-Hodgkin lymphoma.
Blood Adv
December 2024
Molecular and Cellular Immunology, Great Ormond Street Institute of Child Health, London, United Kingdom.
Article Synopsis
- Relapse in B-cell acute lymphoblastic leukaemia (ALL) and B-cell non-Hodgkin lymphoma (B-NHL) after CD19-directed CAR-T cell therapy is a significant issue, prompting the development of dual CAR-T cells targeting CD19 and additional antigens like CD22 or CD20 to reduce relapse rates.
- Various methods for creating dual CAR-T cells include co-administration of separate products, co-transduction of T-cells, and the use of bicistronic vectors or bivalent CARs, with early trials indicating that this approach is safe and maintains good remission rates.
- Despite advancements, challenges remain, including poor CAR-T cell persistence and the fact that
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!