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CD19-directed CAR T cells as first salvage therapy for large B-cell lymphoma: towards a rational approach

The approval of CD19-directed chimeric antigen receptor (CAR) T-cell therapies for the second-line treatment of high-risk large B-cell lymphoma (LBCL) has greatly affected salvage algorithms for this condition, and such therapies could have the potential to improve the course of relapsed or refracto...

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Main Authors: Dreger, Peter (Author) , Corradini, Paolo (Author) , Gribben, John G. (Author) , Glaß, Bertram (Author) , Jerkeman, Mats (Author) , Kersten, Marie Jose (Author) , Morschhauser, Franck (Author) , Mussetti, Alberto (Author) , Viardot, Andreas (Author) , Zinzani, Pier Luigi (Author) , Sureda, Anna (Author)
Format: Article (Journal)
Language:English
Published: December 2023
In: The lancet. Haematology
Year: 2023, Volume: 10, Issue: 12, Pages: e1006-e1015
ISSN:2352-3026
DOI:10.1016/S2352-3026(23)00307-1
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/S2352-3026(23)00307-1
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2352302623003071
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Author Notes:Peter Dreger, Paolo Corradini, John G Gribben, Bertram Glass, Mats Jerkeman, Marie Jose Kersten, Franck Morschhauser, Alberto Mussetti, Andreas Viardot, Pier Luigi Zinzani, Anna Sureda, on behalf of the European Society for Blood and Marrow Transplantation and the European Hematology Association Lymphoma Group
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Summary:The approval of CD19-directed chimeric antigen receptor (CAR) T-cell therapies for the second-line treatment of high-risk large B-cell lymphoma (LBCL) has greatly affected salvage algorithms for this condition, and such therapies could have the potential to improve the course of relapsed or refractory LBCL. In this Review, we provide guidance for a rational management approach to the use of commercial CD19-directed CAR T cells in the second-line treatment of LBCL, addressing crucial questions regarding eligible histologies; age, comorbidity, and tumour biology restrictions; the handling of very aggressive tumour behaviour; and holding and bridging therapies. The guidance was developed in a structured manner and, for each question, consists of a description of the clinical issue, a summary of the evidence, the rationale for a practical management approach, and recommendations. These recommendations could help to decide on the optimal management of patients with relapsed or refractory LBCL who are considered for second-line CAR T-cell treatment.
Item Description:Online verfügbar: 27. November 2023
Gesehen am 21.03.2024
Physical Description:Online Resource
ISSN:2352-3026
DOI:10.1016/S2352-3026(23)00307-1

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