Evaluating dual-target CAR T-cell therapy for patients with unresponsive B-cell NHL

This study evaluated the safety and effectiveness of dual chimeric antigen receptor (CAR) T-cell therapy for patients with recurrent or hard-to-treat B-cell non-Hodgkin lymphoma (NHL). This study found that this treatment was safe and effective for these patients.

B-cell non-Hodgkin’s lymphoma (NHL) is one of the most common types of lymphoma. Chemoimmunotherapy remains the typical first-line treatment for patients. Although effective for many patients, some patients stop responding to treatment. Treatment for these patients is challenging.

CAR T-cell therapy uses genetically modified T-cells (immune cells) to help the immune system attack cancer cells. CAR T-cells can be made to target different molecules on the surface of cancer cells called antigens. Some studies suggest that combining CAR T-cells that target more than one antigen may help improve effectiveness. Whether this dual-target CAR T-cell therapy is safe and effective for patients with B-cell NHL is unclear.

This study included 32 patients with recurrent or unresponsive B-cell NHL. All patients received CAR T-cell therapy targeting CD19/CD22, and 29 patients were included in the final analysis. Patients were followed up for an average of 8.7 months.

Overall, 79.3% of patients responded to treatment. 34.5% of patients had no signs of cancer after treatment (complete response). Patients survived an average of 6.8 months without tumor growth or spread.

Overall, 63.3% of patients were still alive 1 year after treatment. 40.0% of patients were still alive without tumor growth or spread. Among patients who achieved a complete response at 3 months after treatment, 100% of patients were still alive 1 year later, with 66.7% of patients free of tumor growth or spread.

At follow-up, 10 patients had disease progression. On average, relapse occurred at an average of 5.3 months after treatment.

Overall, 93.8% of patients had side effects. Low blood cell coutns were most common. 90.6% of patients developed cytokine release syndrome (CRS). This happens when many immune system molecules called cytokines are released into the blood. These molecules trigger a variety of symptoms in the body, like fever, nausea, and headache. Most cases were able to be resolved with treatment, but 28.1% of patients developed severe CRS. These patients also reported low blood pressure (25.0%), fever (15.6%), and low levels of oxygen in the blood (12.5%).

This study found that dual-target CAR T-cell therapy was safe and effective for patients with relapsed or recurrent B-cell NHL. 

This study had a very small number of patients. More studies are needed to confirm these results.