Common brand names

• Breyanzi

How it is administered

Lisocabtagene maraleucel is given as a one-time intravenous (IV) infusion. The medication is made from your own T cells, which are collected through a process called leukapheresis. These cells are then genetically modified in a laboratory to target cancer cells and are infused back into your bloodstream. Before receiving the infusion, you will be given a short course of chemotherapy (fludarabine and cyclophosphamide) to prepare your body for the treatment. The infusion itself is performed in a hospital or specialized treatment center, and you will be closely monitored for several weeks after receiving the therapy.

How it works

Lisocabtagene maraleucel is a type of CAR T-cell therapy, which stands for Chimeric Antigen Receptor T-cell therapy. This treatment uses your own immune cells (T cells) that are engineered in a lab to recognize and attack cancer cells. Specifically, lisocabtagene maraleucel targets the CD19 protein, which is found on the surface of certain cancerous B cells, including those in mantle cell lymphoma.

After the modified T cells are infused back into your body, they seek out and bind to CD19 on cancer cells. This binding activates the T cells, causing them to multiply and destroy the cancer cells. The therapy is designed to provide a powerful and targeted immune response against your lymphoma, potentially leading to remission, especially in cases where other treatments have not worked.

Who should take it

Lisocabtagene maraleucel is indicated for adults with relapsed or refractory mantle cell lymphoma (MCL) who have received at least two prior lines of systemic therapy, including a Bruton tyrosine kinase (BTK) inhibitor. It is also approved for certain other types of blood cancers, such as large B-cell lymphoma, chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and follicular lymphoma, under specific conditions.

This therapy is generally considered for patients whose disease has not responded to or has returned after standard treatments. It offers a new option for those with limited treatment choices and may be especially valuable for patients who have not achieved lasting remission with other therapies.

Who should not take it

There are no absolute contraindications listed for lisocabtagene maraleucel. However, it should not be given to patients with active, uncontrolled infections or those who have unresolved serious side effects from previous treatments. It is also not recommended for use in pregnant women, as the effects on the fetus are unknown and could be harmful.

Patients with a history of central nervous system (CNS) disorders, significant organ dysfunction, or autoimmune disease requiring immunosuppression may not be eligible for this therapy. Your healthcare team will carefully evaluate your overall health and medical history to determine if this treatment is appropriate for you.

Commonly used with

Lisocabtagene maraleucel is typically used as a single-agent therapy, but it is always preceded by a short course of chemotherapy (fludarabine and cyclophosphamide) to prepare your body for the CAR T-cell infusion. Supportive medications, such as acetaminophen and antihistamines, are given before the infusion to reduce the risk of infusion reactions.

If serious side effects like cytokine release syndrome or neurologic symptoms occur, medications such as tocilizumab (to manage CRS) and corticosteroids may be used to control these reactions.

Commonly tested with

In clinical trials, lisocabtagene maraleucel has been tested in combination with lymphodepleting chemotherapy (fludarabine and cyclophosphamide) as part of the treatment protocol. It has also been evaluated in patients who may require supportive medications like tocilizumab and corticosteroids to manage side effects.

The therapy has not been routinely tested in combination with other anti-cancer agents, as it is intended to be a stand-alone, one-time treatment following the preparatory chemotherapy.