CD19-directed CAR T cells gain traction

• Published in: The lancet oncology 2019-01, Vol.20 (1), p.2-3
• Main Author: Schuster, Stephen J
• Format: Article
• Language: English
• Subjects: Antigens, CD19 - therapeutic use; B-cell lymphoma; CD19 antigen; Chemotherapy; Clinical trials; Cytokines; FDA approval; Humans; Immunotherapy; Immunotherapy, Adoptive; Lymphocytes B; Lymphocytes T; Lymphoma; Lymphoma, B-Cell; Medical prognosis; Patients; Remission; T-Lymphocytes - immunology; Traction
• ISSN: 1470-2045; 1474-5488
• DOI: 10.1016/S1470-2045(18)30900-8

[...]there is reason for optimism about long-term outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma who achieve complete remission after anti-CD19 CAR T-cell therapy. [...]irrespective of these differences, what is remarkable across anti-CD19 CAR T-cell trials in relapsed or refractory diffuse large B-cell lymphoma is the consistent durability of responses, with ongoing responses in 39 (39%) of 101 patients at a median of 27·1 months' follow-up in ZUMA-15 and 35 (35%) of 99 patients at a median of 19·3 months' follow-up in JULIET;3 the emergence of plateaus in curves for response duration and progression-free survival beyond 6 months; the absence of late or unexpected gene-therapy-related events; and the unique but manageable toxicities (ie, cytokine release syndrome and neurotoxicity1,3,5,7). In addition to long-term safety, evidence of B-cell recovery during these sustained remissions was also noted (as in Locke and colleagues' study5), with evidence of immunoglobulin recovery in some patients too.7 When assessing the potential therapeutic effects of CD19-directed CAR T-cell therapies on prognosis for relapsed or refractory diffuse large B-cell lymphoma, it will be necessary to identify the subsets of patients who will benefit from this treatment.