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CAR T-Cell Therapy Advances in Large B Cell Lymphoma
Posted: Jun 18, 2024
CAR T-Cell Therapy Advances in Large B Cell Lymphoma image

On May 22nd, 2024, Dr. David Miklos, a lymphoma specialist at Standford Medicine, joined HealthTree for a webinar about CAR T-cell therapy advances in large B cell lymphomas. You can watch the recording or read the summary below.

Some major points from the webinar are as follows:

  • CAR therapy's roots trace back to stem cell transplantation. This method involves replacing a patient’s diseased blood system with healthy donor stem cells and immune cells. However, these transplants come with significant risks, such as toxicity from high-dose chemotherapy and graft-versus-host disease, where donor cells attack the patient's body.
  • CAR T-cell therapy involves modifying a patient's T-cells to target specific antigens on cancer cells. The first successful CAR T-cell treatments targeted the CD19 antigen found on B-cells, which are involved in various types of lymphomas and leukemias. These modified T-cells are collected, genetically engineered, expanded in a lab, and then infused back into the patient. Once in the body, they multiply rapidly and attack cancer cells.
  • There are three FDA-approved CAR T-cell therapies targeting CD19: axicabtagene ciloleucel (Axi-Cel), tisagenlecleucel (Tisa-Cel), and lisocabtagene maraleucel (Liso-Cel). Each has shown significant success in treating relapsed (disease has returned) or refractory (not responding to treatment) lymphomas.
  • Axi-Cel was the first tested CAR T-cell therapy in the ZUMA-1 trial, showing impressive results in patients with aggressive large B-cell lymphomas.
  • More recently, the ZUMA-7 trial compared Axi-Cel directly with the traditional standard of care (high-dose chemotherapy followed by stem cell transplant) in second-line treatment for relapsed (disease has returned) or refractory (not responding to treatment) lymphoma. The study found that Axi-Cel was significantly more effective, with higher rates of progression-free survival and overall survival.
  • CAR T-cell therapy is not without challenges. One common side effect is cytokine release syndrome (CRS), a flu-like condition that can cause high fever, low blood pressure, and difficulty breathing. 

During the Q&A session, the following questions were addressed:

  • Do you anticipate that in the future creation of cellular therapies, you will have therapies that only target the cancerous B cells and not the healthy B cells, so you can avoid B cell aplasia as a long-term side effect? (timestamp 37:55)
  • What is the CAR T-cell treatment regimen? (timestamp 41:12)
  • Some studies show Axi-Cel is superior to Tisa-Cel in terms of efficacy and side effects. Can you tell us what you think about that? (timestamp 46:11)
  • What do you think about the early prediction of cytokine release syndrome by measuring phosphate and magnesium? (timestamp 50:40)
  • Do you find that CAR T-cell therapy is usually covered by insurance? (timestamp 52:48)

In summary, CAR T-cell therapy represents a monumental advancement in cancer treatment. It provides a personalized, potent, and durable response against aggressive lymphomas, offering new hope to patients who have exhausted other options. As research progresses, CAR T-cell therapy is likely to become an even more powerful tool in the fight against cancer, extending its benefits to more patients and types of cancer.


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The author Kat Richardson

about the author
Kat Richardson

Kat is from Lehi, Utah and is the Health Education Manager for lymphoma. She has worked in healthcare for a decade now, and earned her degree in Community Health Education and Promotion. Kat is passionate about disease prevention as well as improving quality of life and health equity. She enjoys reading, hiking, baking, ice skating, gardening, time with her family and friends, and most of all, spoiling her nieces and nephew. 

Thanks to our HealthTree Community for Diffuse Large B Cell Lymphoma Sponsors:

Regeneron
Bristol Myers Squibb

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