Chimeric antigen receptor T-cell therapy for chronic lymphocytic leukemia: a narrative review

Publication date: Available online 21 July 2017 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Anthony R. Mato, Meghan C. Thompson, Chadi Nabhan, Jakub Svoboda, Stephen J. Schuster The treatment landscape for chronic lymphocytic leukemia (CLL) is changing rapidly. Novel targeted agents such as ibrutinib, venetoclax and idelalisib have made a significant impact on both first line, relapsed/refractory, and high-risk disease. Despite these advances, there are continuous needs for new treatment options, especially for patients who fail or cannot tolerate these novel therapies. In 2011, Porter et al reported the first successful use of autologous chimeric antigen receptor T-cells (CART) directed against CD19 in 3 refractory CLL patients. Several groups have since shown success with similar approaches in various settings of CLL, including ibrutinib failure and in patients who relapse after allogeneic stem cell transplantation. While CD19-directed CART therapy holds great promise in CLL and other diseases, many challenges and questions remain including: optimization of the lymphodepletion regimen prior to CART infusion, optimal dosing of CART cells, a determination of the most effective CART T-cell product [t-cell subset(s)] as well as the optimal combinations and therapeutic sequences, and managing treatment-associated adverse events. Clinical trials addressing these challenges are in process. In this timely review, we analyze current state of CART therapy in CLL a...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research