CAR T-cell therapy for non-Hodgkin’s lymphoma

This article reviewed the effectiveness and safety of CAR T-cell therapy in patients with non-Hodgkin’s lymphoma.

The standard treatment for non-Hodgkin’s lymphoma (NHL) is chemotherapy plus immunotherapy. Patients with high-risk disease tend to become refractory (do not respond to treatment). For these patients, treatment options are limited.

CAR T-cell therapy is a new type of treatment for patients with a poor prognosis. This treatment is usually given after a chemotherapy regimen. In this treatment, T-cells (immune cells) are removed from the blood. The T-cells are genetically modified to make a special protein called CAR. This protein helps the T-cells attack cancer cells. These CAR T-cells are then reintroduced into the patient.

This review analyzed the use of CAR T-cell therapy in NHL.

For aggressive NHL, one study involved 101 patients. These patients had refractory diffuse large B-cell lymphoma (DLBCL). 83% of patients responded to treatment. 54% of patients achieved a complete response (disappearance of all signs of cancer). Progression-free survival (patients alive without return of disease) was 41% at 18 months. Overall survival (patients still alive) was 52% at 18 months.

93% of patients in this trial reported cytokine release syndrome (symptoms associated with rapid release of immune molecules into the blood). 35% of patients reported infections. 64% of patients reported neurotoxicity (side effects in the nervous system). Of these, 13% (cytokine release syndrome), 31% (infections), and 28% (neurotoxicity) were severe to life threatening.

For indolent (painless) NHL, one study involved 32 patients. Of these, 18.9% had follicular lymphoma. 80% of these patients responded to treatment. 40% of patients achieved a complete response. Another study involved 14 patients with refractory follicular lymphoma. 79% of patients responded after 3 months of treatment. 50% of patients achieved a complete response. After a follow-up of 28.6 months, 70% of patients were disease-free.

This article reviewed the effectiveness and safety of CAR T-cell therapy in patients with non-Hodgkin’s lymphoma. These included diffuse large B-cell lymphoma and follicular lymphoma.