Cellular Therapy Updates in B-Cell Lymphoma: The State of the CAR-T

Cancers (Basel). 2021 Oct 15;13(20):5181. doi: 10.3390/cancers13205181.

Abstract

Non-Hodgkin Lymphoma accounts for >460,000 cases and >240,000 deaths globally and >77,000 cases and >20,000 deaths in the U.S. annually, with ~85% of cases being B-cell malignancies. Until recently, patients with relapsed/refractory B-cell lymphoma following standard chemotherapy in combination with anti-CD20 monoclonal antibodies and autologous stem cell transplantation experienced a median overall survival (OS) of <6 months. However, with the approval of four different CD-19 CAR-T therapies between 2017 and 2021, approximately 60-80% of patients receiving CAR-T therapy now achieve an objective response with >3 years median OS. Here, we review the current state of the art of CD19 CAR-T therapies for B-cell lymphomas, focusing on current updates in US FDA-approved products, along with their associated efficacy and toxicities. Lastly, we highlight a selection of promising clinical developments in the field, including various novel strategies to increase CAR-T therapy efficacy while mitigating toxicity.

Keywords: B-cell lymphoma; CAR-T cell; adoptive cell therapy; axicabtagene ciloleucel; brexucabtagene autoleucel; chimeric antigen receptor; cytokine release syndrome; immune effector cell-associated neurotoxicity syndrome; lisocabtagene maraleucel; tisagenlecleucel.

Publication types

  • Review