CAR-modified anti-CD19 T cells for the treatment of B-cell malignancies: rules of the road

Expert Opin Biol Ther. 2014 Jan;14(1):37-49. doi: 10.1517/14712598.2014.860442. Epub 2013 Nov 21.

Abstract

Introduction: Malignancies of the B lymphocyte or its precursor include B-cell non-Hodgkin lymphoma as well as chronic and acute lymphoid leukemias. These are among the most common hematologic malignancies and many patients with B-cell malignancies are incurable. Although most patients initially respond to first-line treatment, relapse is frequent and is associated with a poor prognosis. T cells that are genetically engineered to express chimeric antigen receptors (CARs) recognizing the B-cell-associated molecule CD19 have emerged as a potentially potent and exciting therapeutic modality in recent years.

Areas covered: This review explores the current peer-reviewed publications in the field and a discussion of expert opinion.

Expert opinion: Genetic engineering of T cells has become clinically feasible and appears to be safe. Here we provide an insight into the process of patient selection, engineered T-cell production, infusion procedure, expected toxicities and efficacy of this exciting approach as it is practiced in the treatment of B-cell malignancies. Anti-CD19-redirected T cells likely represent the vanguard of an exciting new approach to treating cancer.

Publication types

  • Review

MeSH terms

  • Animals
  • Antigens, CD19 / metabolism*
  • Genetic Therapy / adverse effects
  • Genetic Therapy / methods*
  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Immunotherapy, Adoptive / methods*
  • Lymphoma, B-Cell / immunology
  • Lymphoma, B-Cell / therapy*
  • Patient Selection
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Antigen, T-Cell / metabolism*
  • Recombinant Proteins / metabolism
  • Recurrence
  • Risk Factors
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / transplantation*
  • Treatment Outcome

Substances

  • Antigens, CD19
  • Receptors, Antigen, T-Cell
  • Recombinant Proteins