CD19 CAR-T Therapy Offers Safe and, Effective Approach for Transformed Indolent Lymphomas

A new study highlights the safety and efficacy of CD19 chimeric antigen receptor (CAR-T) cell therapy for patients with transformed indolent lymphoma compared with De novo aggressive large B-cell lymphoma (LBCL). Charles Gaulin, MBBS, an Assistant Professor of Medicine at Dartmouth Geisel School of Medicine, spoke with Blood Cancers Today about the study’s results and clinical implications.

Approximately 11,000 patients with LBCL received standard of care commercial CD19-targeted CAR-T therapy. The researchers studied efficacy, including response rates, and safety concerning immune effector cell-associated neurotoxicity syndrome (ICANS) and cytokine release syndrome (CRS).

Rates of grade 3 or higher CRS were similar between transformed indolent non-Hodgkin lymphoma and de novo LBCL (7% to 8%), while rates of grade 3 or higher ICANS were lower in patients with transformed indolent non-Hodgkin lymphoma (21% vs 27%). Overall response rates were similar between the two groups (83% and 81%, respectively), but complete response rates were higher in the transformed indolent non-Hodgkin group compared to the de novo LBCL group (67% vs 59%) at a median follow-up of 22 months.

“CD19 targeted CAR-T cell therapy was safe and effective in the treatment of patients with transformed indolent lymphomas compared to those with de Novo aggressive large B cell lymphoma. In terms of toxicity, it may be a little bit more favorable, with reduced rates of severe ICANS,” Dr. Gaulin explained. “The efficacy being similar suggests that perhaps cellular therapy targeting CD19 may overcome some of the historic adverse prognostic features that transformed indolent lymphoma was historically associated with.”