How does CAR-T for MCL work?

There are two types of CAR T-cell therapy approved for MCL in the United States. These include: 

• Brexu-cel (Tecartus)
• Liso-cel (Breyanzi)

Both enhance your T cells to target CD19 on MCL cells. Learn more at: How CAR T-cell Therapy Works.

Which MCL patients can receive CAR-T? 

People with MCL are eligible for the different CAR-T constructs in the following situations: 

• Brexu-cel: Adult patients with relapsed or refractory MCL are eligible. 
• Liso-cel: Adult patients with relapsed or refractory MCL who have received at least 2 prior lines of systemic therapy, including a BTK inhibitor. 

To learn about more factors that may influence whether CAR-T is right for you, visit: When to Consider CAR-T Cell Therapy?

When will my CAR-T infusion for MCL be ready? 

The CAR-T process takes time. After collecting your T-cells, it takes up to 4 weeks for the CAR-T infusion to be ready. 

During this waiting period, your doctor may recommend a temporary bridging therapy like corticosteroids or radiotherapy to help keep MCL under control until your CAR-T infusion. 

How is CAR T-cell therapy administered for MCL?

Before your CAR-T infusion, you will receive a short course of chemotherapy with cyclophosphamide and fludarabine through an IV daily for 3 days. This step is called lymphodepletion. It helps prepare your body so CAR-T works more effectively. Your CAR-T infusion is typically given 2 to 4 days after this chemotherapy. If you experience serious side effects from lymphodepletion, active infections, or inflammatory disorders, the CAR-T infusion may be delayed until these side effects are resolved. 

About 30 to 60 minutes before the CAR-T infusion, you will be given acetaminophen and diphenhydramine by your healthcare team to help lower the risk of side effects. The CAR-T infusion itself takes between 30 and 60 minutes.  

Afterward, you will be monitored closely for at least 7 days. This is to watch for possible side effects such as cytokine release syndrome (CRS) and neurological changes. You will also need to stay near the treatment center and avoid driving for at least 2 weeks after the infusion. The requirements used to be longer but were recently updated based on the FDA’s removal of the Risk Evaluation and Mitigation Strategies (REMS). 

Brexu-cel (Tecartus) for MCL 

How effective is brexu-cel for MCL? 

Results from the ZUMA-2 study, which tested brexu-cel after two or more treatments for people with relapsed or refractory MCL, showed that 62% of participants experienced a complete remission and 25% a partial remission. After a median follow-up of 8.6 months, more than half of the participants remained in remission. 

Side effect profile of brexu-cel for MCL 

The data below shows the percentage of people with MCL who experienced the 5 most common and severe side effects from brexu-cel in the ZUMA-2 trial. This information can help you understand what to expect and prepare for, as well as guide conversations with your care team about managing potential side effects. 

The 5 most common side effects (any grade) that MCL patients experienced after receiving brexu-cel were: 

• Fever: 94%
• Cytokine release syndrome: 91%
• Infections: 74%
• Hypotension (low blood pressure): 57%
• Encephalopathy (a group of conditions that cause brain dysfunction): 51% 

The 5 most severe side effects in which patients required supportive hospital care (grades 3 and higher), apart from low blood counts, included: 

• Infections: 34% 
• Hypotension (low blood pressure): 27%
• Encephalopathy (a group of conditions that cause brain dysfunction): 24%
• Hypoxia (low levels of oxygen in body tissues): 20%
• Cytokine release syndrome: 18%

For more information on brexu-cel for MCL, check out the source below. 

• Tecartus Prescribing Information

For information on how to manage CAR-T side effects, visit: Side Effect Management of CAR T-cell Therapy for Lymphoma.

Liso-cel (Breyanzi) for MCL (header 2)

How effective is liso-cel for MCL? (header 3)

Results from the TRANSCEND-MCL study, which tested liso-cel after two or more treatments for people with relapsed or refractory MCL, showed that 46% of participants experienced a complete remission, which lasted for a median of 17.5 months. 12% of patients experienced a partial remission, which lasted for a median of 2.2 months. 

Side effect profile of liso-cel for MCL (header 3)

The data below shows the percentage of people with MCL who experienced the 5 most common and severe side effects from liso-cel in the TRANSCEND-MCL trial. This information can help you understand what to expect and prepare for, as well as guide conversations with your care team about managing potential side effects. 

The 5 most common side effects (any grade) that MCL patients experienced after receiving liso-cel were: 

• Cytokine release syndrome: 61% 
• Fatigue: 39%
• Musculoskeletal (muscle/bone) pain: 38%
• Encephalopathy (a group of conditions that cause brain dysfunction): 30% 
• Edema (swelling in limbs from trapped fluid): 25%

The 5 most severe side effects in which patients required supportive hospital care (grades 3 and higher), apart from low blood counts, included: 

• Encephalopathy (a group of conditions that cause brain dysfunction): 9% 
• Infections: 8.3%
• Decreased appetite: 4.5%
• Tachycardia (fast heartbeat): 3.4%
• Abdominal (stomach) pain: 3.4%

For more information on liso-cel for MCL, check out the source below. 

• Breyanzi Prescribing Information

For information on how to manage CAR-T side effects, visit: Side Effect Management of CAR T-cell Therapy for Lymphoma.

Financial resources for MCL CAR-T

To locate financial resources for MCL CAR T-cell therapies like brexu-cel and liso-cel, visit: Financial Resources for Lymphoma CAR-T.