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Review
. 2020 Jan 29:11:2040620720902899.
doi: 10.1177/2040620720902899. eCollection 2020.

Safety and efficacy of axicabtagene ciloleucel in refractory large B-cell lymphomas

Peter A Riedell  1 , Michael R Bishop  2
Affiliations
Review

Safety and efficacy of axicabtagene ciloleucel in refractory large B-cell lymphomas

Peter A Riedell et al. Ther Adv Hematol. .

Abstract

Aggressive large B-cell lymphomas represent a diverse population of diseases that are typically treated with anti-CD20 based immunochemotherapy. While this treatment is effective for a large proportion of patients, those that become refractory to induction therapy or experience disease relapse suffer an inferior overall prognosis, and novel treatment options are needed. Adoptive T-cell immunotherapy in the form of chimeric antigen receptor (CAR) T-cell therapy is one of the most revolutionary breakthroughs in the past several decades for the treatment of relapsed/refractory aggressive large B-cell lymphomas. Based on data from the pivotal ZUMA-1 study, axicabtagene ciloleucel (axi-cel) became the first-in-class anti-CD19 directed CAR T-cell therapy approved for patients with diffuse large B-cell lymphoma and other aggressive B-cell lymphoma variants. In this review, we provide an overview of CAR T-cell therapy, including its biology, manufacturing, and treatment course. In addition, we highlight the available efficacy data, review pertinent safety concerns, including cytokine release syndrome and neurologic toxicity, as well as provide an overview of emerging therapeutic strategies in the cellular therapy arena.

Keywords: CAR T-cell; NHL; axicabtagene ciloleucel; diffuse large B-cell lymphoma; immunotherapy; refractory.

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Conflict of interest statement

Conflict of interest statement: Peter Riedell has served on the advisory board for Kite/Gilead, Verastem, Celgene, and Bayer. He has served as a speaker and performed consulting for Bayer and Kite/Gilead. He receives institutional research funding from Celgene/Juno, Novartis, and Kite/Gilead. Michael Bishop has performed consulting and served on the advisory board for Kite/Gilead, Novartis, Celgene/Juno, CRISPR Therapeutics, and Celgene. He has also served on the advisory board for Seattle Genetics, Pharmacyclics, and United Healthcare and serves as a speaker for Kite/Gilead and Celgene.

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