Common brand names

• Tecartus

How it is administered

Brexucabtagene autoleucel is given as a single intravenous (IV) infusion. It is an autologous cell therapy, meaning it is made from your own T cells, which are collected through a process called leukapheresis. These cells are then genetically modified and expanded in a laboratory before being infused back into your bloodstream. The infusion is prepared as a frozen suspension and thawed just before administration.

Before receiving brexucabtagene autoleucel, you will receive a short course of chemotherapy (lymphodepleting regimen) to prepare your body for the treatment. Premedication with acetaminophen and diphenhydramine is also recommended to reduce the risk of infusion reactions.

How it works

Brexucabtagene autoleucel is a type of CAR T-cell therapy. It works by using your own immune system to fight cancer. First, your T cells (a type of white blood cell) are collected and genetically modified in a laboratory to express a special receptor called a chimeric antigen receptor (CAR) on their surface. This CAR is designed to recognize and bind to a protein called CD19, which is found on the surface of certain cancer cells, including those in mantle cell lymphoma (MCL).

Once these modified T cells are infused back into your body, they seek out and attach to CD19-expressing cancer cells. The CAR on the T cells activates them, causing them to multiply and release substances that kill the cancer cells. This targeted approach helps your immune system specifically attack the cancer while sparing most normal cells.

Who should take it

Brexucabtagene autoleucel is indicated for adult patients with relapsed or refractory mantle cell lymphoma (MCL). This means it is used when the disease has returned after previous treatments or has not responded to other therapies. It is typically considered for patients who have already received other types of chemotherapy, an anti-CD20 antibody, and a Bruton tyrosine kinase inhibitor (such as ibrutinib or acalabrutinib).

Your healthcare team will determine if this therapy is appropriate for you based on your overall health, previous treatments, and specific characteristics of your lymphoma.

Who should not take it

There are no absolute contraindications listed for brexucabtagene autoleucel, but it should not be given to patients with active, serious infections or those who are not healthy enough to undergo the required procedures and monitoring. It is not recommended for use in pregnant women, as it may harm the fetus. The safety and effectiveness in pediatric patients have not been established.

Patients with a history of central nervous system lymphoma, active brain metastases, or certain neurological disorders may not be eligible for this therapy. Your doctor will carefully evaluate your medical history to ensure this treatment is safe for you.

Commonly used with

Before receiving brexucabtagene autoleucel, patients are typically given a lymphodepleting chemotherapy regimen, which includes cyclophosphamide and fludarabine. These medications help prepare the body for the CAR T-cell infusion by reducing the number of normal immune cells, making space for the modified T cells to expand and work more effectively.

Medications such as acetaminophen and diphenhydramine are used before the infusion to reduce the risk of infusion reactions. Tocilizumab and corticosteroids may be used to manage side effects like cytokine release syndrome or neurologic toxicities if they occur.

Commonly tested with

Brexucabtagene autoleucel has been studied in combination with lymphodepleting chemotherapy agents, specifically cyclophosphamide and fludarabine. These are given prior to the CAR T-cell infusion to enhance the effectiveness of the treatment.

During and after treatment, supportive medications such as tocilizumab (for cytokine release syndrome) and corticosteroids (for severe side effects) are commonly used as needed. The use of these medications is based on the patient's response and any side effects experienced during therapy.