Large-B-cell lymphoma (LBCL) is one of the most common types of non-Hodgkin lymphoma, and many patients do not respond well to standard first-line chemoimmunotherapy regimes. Notably, complete response rates for disappearance of all cancer in patients with high-risk LBCL are less than 60%; high-risk LBCL is characterized by positive positron emission tomography-computed tomography (PET-CT) and gene rearrangements of MYC and BCL2 and/or BCL6 (i.e. double- or triple-hit lymphomas). Chimeric antigen receptor (CAR) T-cells are a promising therapy used to treat hematological cancers by targeting CD-19, a biomarker for B-cells. Axicabtagene ciloleucel (axi-cel), an anti-CD-19 CAR T-cell therapy, has been approved for patients with refractory LBCL, and the results of the ZUMA-12 phase 2 single-arm, multi-center trial suggest that axi-cel may be helpful as a first-line therapy in this population. During 2019-2020, axi-cel was made and administered to 40 of the 42 patients enrolled in the study with a complete response rate of 78% (95% C.I., 62-90). Furthermore, the adverse events were manageable. Additional research is needed to confirm these results, but CAR-T cell therapies may also be helpful as a therapy for some lower-risk patients with LBCL.
Reference:
