Case report: CD19-directed CAR-T cell therapy combined with BTK inhibitor and PD-1 antibody against secondary central nervous system lymphoma

Front Immunol. 2022 Oct 5:13:983934. doi: 10.3389/fimmu.2022.983934. eCollection 2022.

Abstract

Current therapeutic strategies for central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL) are extremely limited. Secondary central nervous system lymphoma (SCNSL) also shows a grave prognosis and high mortality. This report describes a young female patient with DLBCL and CNS relapse who received low-dose CD19-directed chimeric antigen receptor T (CAR-T) cell therapy followed with Bruton's tyrosine kinase inhibitor and programmed cell death protein 1 antibody after several lines of chemotherapy. However, limited reports on CAR-T cell therapy are applied for SCNSL, particularly those in combination with targeted agents. The current treatment combination for this case provides a new regimen for CNS relapse from DLBCL.

Clinical trial registration: ClinicalTrials.gov number, NCT04666168.

Keywords: BTK inhibitor; CD19 CAR-T cell therapy; PD-1 antibody; scnsl; tislelizumab; zanubrutinib.

Publication types

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

MeSH terms

  • Antigens, CD19
  • Cell- and Tissue-Based Therapy
  • Central Nervous System
  • Central Nervous System Neoplasms* / pathology
  • Central Nervous System Neoplasms* / therapy
  • Clinical Trials as Topic
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasms, Second Primary*
  • Programmed Cell Death 1 Receptor
  • Protein Kinase Inhibitors / therapeutic use
  • Receptors, Chimeric Antigen*

Substances

  • Antigens, CD19
  • Programmed Cell Death 1 Receptor
  • Protein Kinase Inhibitors
  • Receptors, Chimeric Antigen

Associated data

  • ClinicalTrials.gov/NCT04666168