The role of axicabtagene ciloleucel as a treatment option for patients with follicular/marginal zone lymphoma

Sandoval-Sus, José; Chávez, Julio C.

doi:10.1177/20406207211017788

Cited by 4 publications

(6 citation statements)

References 88 publications

(142 reference statements)

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“…Axicabtagene ciloleucel (axi-cel) is approved for relapsed/refractory DLBCL and follicular lymphoma in adults. 13 In the initial phase 2, multicenter study axi-cel showed an overall response rate of 82%, complete response rate of 54% at 6 months, and an overall survival rate of 52% at 18 months. 14 Brexucabtagene autoleucel is approved for relapsed/refractory mantle cell lymphoma (MCL) and B-ALL.…”

Section: Overview Of Current Fda-approved Car T-cell Therapiesmentioning

confidence: 98%

Adverse Cardiac Effects of CAR T-Cell Therapy: Characteristics, Surveillance, Management, and Future Research Directions

Dalal

Patel

Feinstein

et al. 2022

Technol Cancer Res Treat

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This review summarizes the current literature on the adverse cardiac effects of CAR T-cell therapy. Case reports and series suggest that major adverse cardiovascular events are not uncommon after CAR T-cell therapy; however, limited data exist regarding incidence, pathophysiology, and prevention strategies related to CAR T-associated cardiovascular events. As cellular therapy advances and the indications for its use continue to expand, it is essential to better understand its associated cardiovascular toxicities. Biomarkers, cardiac imaging, longitudinal data from larger populations, and translational research are all essential areas for further research. Interestingly, CAR T-cell therapy can also be used to reverse cardiac fibrosis in murine models. Altogether this underscores the need to broadly understand how T-cells, endogenous and engineered, may impact cardiovascular diseases.

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Section: Overview Of Current Fda-approved Car T-cell Therapiesmentioning

confidence: 98%

Adverse Cardiac Effects of CAR T-Cell Therapy: Characteristics, Surveillance, Management, and Future Research Directions

Dalal

Patel

Feinstein

et al. 2022

Technol Cancer Res Treat

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“…Yescarta (axicbtagene ciloleucel) is an anti-CD19 autologous CAR T cell that has an overall and complete rate of 83 and 58 percent, respectively, for the treatment of adult patients with relapsed or refractory large B cell lymphoma 25 and adult patients with relapsed or refractory follicular lymphoma (FL). 4 To manufacture Yescarta, autologous T cells are extracted and retrovirally engineered to express CAR with a murine anti-CD19 scFv coupled to CD28 and CD3-zeta costimulatory domains. The CRS (in all grades) was recorded in roughly 94 percent of patients treated with Yescarta, whereas a higher grade of CRS was seen in 13% of those controlled with tocilizumab and corticosteroid therapy.…”

Section: Car T Cell Therapy In Cancermentioning

confidence: 99%

“…1 This approach has indicated a remarkable outcome in the treatment of patients with paediatric acute lymphoblastic lymphoma (ALL) in addition to the treatment of other cancers, such as diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), and multiple myeloma. [2][3][4][5][6] Due to the success of CAR T cell therapy in cancer, researchers were encouraged to extend its application to other diseases. Furthermore, as T cells are key players in tackling viral infections, such as infections caused by the human immunodeficiency virus (HIV).…”

Section: Introductionmentioning

confidence: 99%

“…Chimaeric antigen receptors (CARs) have already shown great potential to reinforce T cells against tumours with specific surface markers 1 . This approach has indicated a remarkable outcome in the treatment of patients with paediatric acute lymphoblastic lymphoma (ALL) in addition to the treatment of other cancers, such as diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), and multiple myeloma 2–6 . Due to the success of CAR T cell therapy in cancer, researchers were encouraged to extend its application to other diseases.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic roles of CAR T cells in infectious diseases: Clinical lessons learnt from cancer

Mohammadi

Akhoundi

Malih

et al. 2022

Reviews in Medical Virology

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Cancer immunotherapy has made improvements due to the advances in chimaeric antigen receptor (CAR) T cell development, offering a promising treatment option for patients who have failed to respond to traditional treatments. In light of the successful use of adoptive CAR T cell therapy for cancer, researchers have been inspired to develop CARs for the treatment of other diseases beyond cancers such as viral infectious diseases. Nonetheless, various obstacles limit the efficacy of CAR T cell therapies and prevent their widespread usage. Severe toxicities, poor in vivo persistence, antigen escape, and heterogeneity, as well as off-target effect, are key challenges that must all be addressed to broaden the application of CAR T cells to a wider spectrum of diseases. The key advances in CAR T cell treatment for cancer and viral infections are reviewed in this article. We will also discuss revolutionary CAR T cell products developed to improve and enhance the therapeutic advantages of these treatments.

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“…Chimeric antigen receptor (CAR)-T-cell therapy is a novel type of tumor immunotherapy that has improved outcomes for many patients with relapsed or refractory (R/R) lymphomas, showing varied efficacy in diffuse large B-cell lymphoma (DLBCL) (objective response rate (ORR) 52-88%; complete response (CR) 40-59% ( 3 ), mantle cell lymphoma (MCL) (CR 59%) ( 4 ), and chronic lymphocytic leukemia (CLL) (ORR 57-74%; CR 21%) ( 5 ). To date, several CAR-T-cell therapies have received FDA approval in the USA, including axicabtagene ciloleucel (axi-cel) ( 6 ) and lisocabtagene maraleucel (liso-cel) ( 7 ) for R/R DLBCL, axi-cel for R/R follicular lymphoma (FL) ( 8 ), and brexucabtagene autoleucel (brexu-cel) for R/R MCL and B-cell acute lymphoblastic leukemia (ALL) in adults ( 4 ). CAR-T-cell therapy has had a substantial impact on overall survival (OS) and progression-free survival (PFS), but it also comes with a host of adverse events (AEs), including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which can lead to treatment failure ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Cytopenia after chimeric antigen receptor T cell immunotherapy in relapsed or refractory lymphoma

et al. 2022

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BackgroundPatients with relapsed or refractory (R/R) lymphomas have benefited from chimeric antigen receptor (CAR)-T-cell therapy. However, this treatment is linked to a high frequency of adverse events (AEs), such as cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and hematologic toxicity. There has been increasing interest in hematological toxicity in recent years, as it can result in additional complications, such as infection or hemorrhage, which remain intractable.MethodsWe conducted a retrospective, single-institution study to evaluate the patterns and outcomes of cytopenia following CAR-T-cell infusion and potential associated factors.ResultsOverall, 133 patients with R/R lymphoma who received CAR-T-cell therapy from June, 2017 to April, 2022 were included in this analysis. Severe neutropenia, anemia and thrombocytopenia occurred frequently (71, 30 and 41%, respectively) after CAR-T-cell infusion. A total of 98% of severe neutropenia and all severe thrombocytopenia cases occurred in the early phase. Early severe cytopenia was associated with CRS incidence and severity, as well as peak inflammatory factor (IL-6, C-reactive protein (CRP), and ferritin) levels. In multivariate analysis, prior hematopoietic stem cell transplantation (HSCT), baseline hemoglobin (HB), and lymphodepleting chemotherapy were independent adverse factors associated with early severe cytopenia. In addition, 18% and 35% of patients had late neutrophil- and platelet (PLT)-related toxicity, respectively. In multivariate analysis, lower baseline PLT count was an independent factor associated with late thrombocytopenia. More severe cytopenia was associated with higher infection rates and poorer survival.ConclusionsThis research indicates that improved selection of patients and management of CRS may help to decrease the severity of cytopenias and associated AEs and improve survival following CAR-T-cell therapy.Clinical Trial Registrationhttps://www.clinicaltrials.gov/ct2/show/NCT03196830, identifier NCT03196830.

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The role of axicabtagene ciloleucel as a treatment option for patients with follicular/marginal zone lymphoma

Cited by 4 publications

References 88 publications

Adverse Cardiac Effects of CAR T-Cell Therapy: Characteristics, Surveillance, Management, and Future Research Directions

Adverse Cardiac Effects of CAR T-Cell Therapy: Characteristics, Surveillance, Management, and Future Research Directions

Therapeutic roles of CAR T cells in infectious diseases: Clinical lessons learnt from cancer

Cytopenia after chimeric antigen receptor T cell immunotherapy in relapsed or refractory lymphoma

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