Modern management of relapsed and refractory aggressive B-cell lymphoma: A perspective on the current treatment landscape and patient selection for CAR T-cell therapy

Veronika Bachanova, Miguel Angel Perales, Jeremy S. Abramson

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Approximately 65% of patients with diffuse large B-cell lymphoma are cured with first-line therapy. However, approximately 10% to 15% exhibit primary refractory disease, and 20% to 25% experience relapse after initial response. Eligible patients receive second-line therapy followed by high-dose chemotherapy and an autologous hematopoietic stem cell transplant, previously the only potentially curative option for this population. Recently approved chimeric antigen receptor (CAR) T-cell therapies offer an alternative curative option for patients who have experienced a second-line or later relapse or whose disease is refractory. CD19-targeting CAR T cells are autologous T cells expressing an anti-CD19 CAR that, when reintroduced to the patient, identify and kill CD19+ B cells. Because of the novelty of CAR T-cell therapy and the complexity of this patient population, identification of ideal candidates is still being defined. This article summarizes 3 patient cases, focusing on the important aspects of patient selection for CAR T-cell therapy.

Original languageEnglish (US)
Article number100640
JournalBlood Reviews
Volume40
DOIs
StatePublished - Mar 2020

Bibliographical note

Funding Information:
Veronika Bachanova has received research funding from Novartis, Gamida Cell, GT Biopharma, Incyte, Bristol-Myers Squibb, and Unum Therapeutics and has served on advisory boards for Kite—a Gilead Company, Seattle Genetics, and Unum Therapeutics. Miguel-Angel Perales has received honoraria from AbbVie, Bellicum, Bristol-Myers Squibb, Incyte, Merck, Novartis, Nektar Therapeutics, and Takeda; has received research support for clinical trials from Incyte and Miltenyi Biotec; and serves on data and safety monitoring boards for Servier and Medigene and scientific advisory boards for MolMed and NexImmune. Jeremy S. Abramson has served as a consultant for AbbVie, Amgen, Bayer, Celgene, EMD Serono, Genentech, Gilead, Janssen, Juno Therapeutics, Kite—a Gilead Company, Merck, Novartis, and Seattle Genetics.

Funding Information:
Editorial assistance was provided by Nicole Hjortland, PhD, and John Togneri, PhD (ArticulateScience LLC), and was funded by Novartis Pharmaceuticals Corporation .

Publisher Copyright:
© 2019

Keywords

  • CAR T-cell therapy
  • Chimeric antigen receptor
  • Diffuse large B-cell lymphoma

PubMed: MeSH publication types

  • Case Reports
  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Review

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