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.
Bibliographical noteFunding 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.
Editorial assistance was provided by Nicole Hjortland, PhD, and John Togneri, PhD (ArticulateScience LLC), and was funded by Novartis Pharmaceuticals Corporation .
- 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