Tisagenlecleucel CAR T-cell therapy in secondary CNS lymphoma.
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ABSTRACT:
SUBMITTER: Frigault MJ
PROVIDER: S-EPMC7022436 | biostudies-literature | 2019 Sep
REPOSITORIES: biostudies-literature
Publications
Tisagenlecleucel CAR T-cell therapy in secondary CNS lymphoma.
Frigault Matthew J MJ Dietrich Jorg J Martinez-Lage Maria M Leick Mark M Choi Bryan D BD DeFilipp Zachariah Z Chen Yi-Bin YB Abramson Jeremy J Crombie Jennifer J Armand Philippe P Nayak Lakshmi L Panzini Chris C Riley Lauren S LS Gallagher Kathleen K Maus Marcela V MV
Blood 20190718 11
Chimeric antigen receptor (CAR) T cells targeting CD19 have emerged as a leading engineered T-cell therapy for relapsed/refractory B-cell non-Hodgkin lymphoma. The phase 1/2 clinical trials that led to US Food and Drug Administration approval excluded patients with central nervous system (CNS) involvement, due to strict eligibility criteria. Here, we report on our institutional experience with 8 secondary CNS lymphoma patients treated with commercial tisagenlecleucel. No patient experienced grea ...[more]
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Project description:BackgroundThe aggressive form of Mantle cell non-hodgkin B cell lymphoma (MCL) has a dismal prognosis. Dual targeting BTK and BCL2 with ibrutinib and venetoclax has improved outcomes in MCL patients who were predicted not to respond to conventional therapy, but it is unlikely to be curative. Chimeric antigen receptor-modified T (CAR T) cells exhibit very effective function in elimination of relapsed/refractory B-cell lymphoid malignancies, we investigated their use in a patient with relapsed MCL.Case presentationHere, we report a case of a refractory MCL in a patient who had relapsed after conventional chemotherapy and autologous CAR T cell therapy. The patient received multiple molecularly targeted therapies, including targeting BTK and BCL2, and haplo-identical CAR T (haplo-CAR T) cells from her daughter without previous allo-hematopoietic stem cell transplantation. Haplo-CAR T cells could effectively proliferate in vivo and had a clinically significant antitumor activity without serious side effects. The patient achieved a partial remission, with minimal residual disease.ConclusionsThis case suggests that haplo-CAR T cell therapy can be effective in controlling lymphoma that failed to respond to autologous CAR T cell therapy and overcome limitation of autologous CAR T cells, thus may be one possible regimen before the era of off-the-shelf "universal" CAR T cell therapy.Trial registrationChiCTR-OPN-16008526. http://www.chictr.org.cn/showproj.aspx?proj=13798 ; ChiCTR1800019385. http://www.chictr.org.cn/showproj.aspx?proj=32805 ; ChiCTR1800019449. http://www.chictr.org.cn/showproj.aspx?proj=32778 .
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