What If My CAR-T Therapy Fails?

CAR-T cell therapy has revolutionized DLBCL treatment, offering long periods of remission without treatment for many patients. However, a subset of patients experience relapse after CAR-T treatment. This article explores potential treatment options for those facing CAR-T relapse and emphasizes the importance of working with your doctor to create a personalized treatment plan.

Treatment Options After CAR-T Failure

While CAR-T therapy offers significant advantages, some patients experience relapse after treatment. Standard chemotherapy options may show limited effectiveness in such cases. Fortunately, ongoing research is exploring new strategies to address post-CAR-T relapse.

• Second CAR-T Infusion

In specific situations, a second CAR-T infusion might be an option, particularly if the initial treatment resulted in a rapid decline of CAR-T cells. Factors like cell availability, patient health post-first infusion, and relapse status will determine eligibility for this approach.

Related articles:

• CAR T-Cell Therapy Advances In Large B Cell Lymphoma
• A Deep Dive Into CAR T-Cell Vs. Bispecific Antibodies For Relapsed Or Refractory DLBCL

• Immunotherapy

Bispecific antibodies are a promising new approach. These "molecular bridges" connect T-cells to cancer cells, enhancing tumor cell recognition and destruction. Epcoritamab is one such antibody showing potential success after CAR-T failure.

Read more here: Bispecific Antibodies for Relapsed or Refractory DLBCL.

• Therapy combinations

Lenalidomide, an immunomodulator drug, can be considered alongside other immune-based therapies. The same goes for tafasitamab if there is some CD19 positivity after the initial treatment.

Learn about brentuximab vedotin, an antibody-drug-conjugate that is being investigated in combination with lenalidomide and rituximab.

• Platinum Salvage Regimen

For patients receiving a second CAR-T infusion, a platinum-based salvage regimen might be explored. However, further research is needed to determine the effectiveness of this approach compared to other options.

Individualized Treatment Plans

The optimal treatment approach when progressing after CAR-T will vary depending on each patient's unique circumstances. Working closely with your doctor is crucial for creating a personalized treatment plan that considers your specific case, medical history, and overall health.

Clinical Trials

Clinical trials play a vital role in advancing treatment options for cancer patients. Discussing participation in relevant clinical trials with your doctor might be an option. They can provide access to cutting-edge therapies that are not yet widely available.

Check the HealthTree Clinical Trial Finder tool to explore which studies are recruiting participants near you.

Review the available treatment options with Dr. Tycel Phillips from City of Hope 

treatment options for dlbcl webinar

Sources:

• An Unclear Path: What’s the Best Route After CAR-T Failure in B-Cell Lymphoma?