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Review
. 2019 Nov;25(11):e344-e351.
doi: 10.1016/j.bbmt.2019.06.036. Epub 2019 Jul 4.

Understanding and Managing Large B Cell Lymphoma Relapses after Chimeric Antigen Receptor T Cell Therapy

Michael Byrne  1 , Olalekan O Oluwole  1 , Bipin Savani  1 , Navneet S Majhail  2 , Brian T Hill  2 , Fredrick L Locke  3
Affiliations
Review

Understanding and Managing Large B Cell Lymphoma Relapses after Chimeric Antigen Receptor T Cell Therapy

Michael Byrne et al. Biol Blood Marrow Transplant. 2019 Nov.

Abstract

Most patients with large cell lymphoma are cured with frontline chemoimmunotherapy. For individuals with refractory disease and those who relapse after conventional therapies, chimeric antigen receptor (CAR) T cells are an important treatment option and have led to remissions in otherwise refractory patients. In the pivotal trials, durable responses were achieved in approximately 40% to 50% of patients treated with axicabtagene ciloleucel, tisagenlecleucel, or lisocabtagene maraleucel, indicating that many patients will require subsequent treatment. Failure after CAR T cell therapy is caused by a variety of factors that can be divided into 3 broad categories: tumor intrinsic factors, other host factors, and inadequacies of the CAR T cells. Within this framework, this article reviews possible mechanisms of treatment failures and, based on the timing of relapse, considers potential salvage therapies and opportunities for future clinical studies.

Keywords: CAR T cell; Diffuse large B cell lymphoma; Relapse.

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Conflict of interest statement

Conflict of interest statement: There are no conflicts of interest to report.

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