{"id":26798,"date":"2021-02-22T13:31:00","date_gmt":"2021-02-22T13:31:00","guid":{"rendered":"http:\/\/a4b0b9a84f607da6ece49c89e617c210"},"modified":"2024-11-03T15:15:46","modified_gmt":"2024-11-03T15:15:46","slug":"five-year-outcomes-with-car-t-cell-therapy","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/five-year-outcomes-with-car-t-cell-therapy\/","title":{"rendered":"Five-Year Outcomes with CAR T Cell Therapy"},"content":{"rendered":"

The results of 5-year follow-up in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma who were treated with CD19-directed, 4-1BB costimulated chimeric antigen receptor  (CAR) T cells (tisagenlecleucel) were reported on 18 February 2021 in The New England Journal of Medicine<\/em>. The researchers from the University of Pennsylvania in Philadelphia, PA, US reported that most responses observed at 1 year were sustained at 5 years. No unexpected late safety concerns emerged in their single centre study.<\/p>\n

The authors wrote that data on outcomes beyond 2 years after CAR T cell infusion are limited. They previously reported 28-month outcomes from the NCT02030834 study and in the latest article they report the results of the 5-year outcomes. Patients were followed for a median of 60.7 months.<\/p>\n

Complete or partial responses were observed in 14 of 24 patients with DLBCL with best overall response 58%, and 11 of 24 patients (46%) having a complete response. At 5 years, progression-free survival was 31% (95% confidence interval [CI] 14 to 51). The median duration of response was 61.4 months with 60% of patients having a sustained response at 5 years.<\/p>\n

Among patients with follicular lymphoma, complete or partial responses were observed in 11 of 14 patients with best overall response 79%, and 10 of 14 (71%) having a complete response. At 5 years, 43% of patients (95% CI 18 to 66) were progression-free. The median duration of response has not been reached and 60% had a sustained response at 5 years.<\/p>\n

Lymphodepletion regimens varied, but did not affect clinical outcomes.<\/p>\n

In patients who had complete remissions beyond 1 year, the CAR19 transgene was continuously detectable throughout the follow-up period in 6 of 12 patients by quantitative polymerase-chain-reaction assay; transgene could not be detected in 4 patients between 32.7 and 47.8 months, and the remaining patients had CAR19 transgene levels that alternated between detectable and undetectable levels. Among 18 patients who had a relapse of lymphoma within 1 year, only 1 had loss of transgene persistence. Among 5 patients who had a relapse beyond 1 year, 3 had undetectable transgene levels.<\/p>\n

Among all patients who had relapse or progression of lymphoma, only 1 of 12 had loss of CD19 expression on tumour cells, assessed by flow cytometry, despite persistence of CAR19 transgene. No patient who had a relapse of lymphoma after 1 year had loss of CD19 expression on tumour cells by flow cytometry.<\/p>\n

The median time from the start of infusion to resolution of all cytopenias was 56 days.<\/p>\n

Within 2 years, 11 of 16 patients who were in complete remission beyond 1 year had recovery of B cells, and 9 of 11 had detectable CAR19 transgene at the time of B cell recovery. At 5 years, 11 of 16 patients had normal IgM levels, 9 of 16 had normal IgA levels, and 6 of 16 had normal IgG levels. Intravenous immunoglobulin treatment was started in 6 of 22 patients who had a response. All patients who remained in remission beyond 1 year recovered normal CD3, CD4, and CD8 T cell counts.<\/p>\n

Secondary cancers occurred in 6 of 38 patients (16%).<\/p>\n

No cases of replication-competent lentivirus were detected.<\/p>\n

The University of Pennsylvania lymphoma programme investigators commented that although this was a single centre study with a relatively small number of patients, the results of 5-year follow-up indicate that alternative approaches to lymphodepletion are feasible, and cellular and humoral immunity often recover.<\/p>\n

The study was supported by Novartis and by a grant from the Lymphoma Research Foundation.<\/p>\n

Reference<\/h4>\n

Chong EA, Ruella, M, Schuster SJ. Five-Year Outcomes for Refractory B-Cell Lymphomas with CAR T-Cell Therapy<\/a>. N Engl J Med<\/em> 2021; 384:673-674
DOI: 10.1056\/NEJMc2030164.<\/p>\n

Source<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

The results of 5-year follow-up in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma who were treated with CD19-directed, 4-1BB costimulated chimeric antigen receptor  (CAR) T cells (tisagenlecleucel) were reported on 18 February 2021 in The New England Journal of Medicine. The researchers from the University of Pennsylvania in Philadelphia, […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-26798","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26798","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=26798"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26798\/revisions"}],"predecessor-version":[{"id":45406,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26798\/revisions\/45406"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=26798"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=26798"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=26798"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}