SOHO State of the Art Updates and Next Questions: Recent advances in CAR-T cell therapy for Non-Hodgkin lymphoma

Publication date: Available online 2 October 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Avyakta Kallam, Julie M. VoseAbstractNon-Hodgkin lymphomas that are refractory to or relapse after frontline chemoimmunotherapy have a poor prognosis. Although high dose chemotherapy, followed by autologous stem cell transplantation remains the standard of care at relapse, this treatment modality leads to a cure in less than 50% of the patients. Adoptive cellular immunotherapy with anti CD 19 chimeric antigen receptor (CAR) T cell has changed the treatment landscape in B cell lymphomas. They have emerged as effective therapy in patients with multiple relapsed/refractory disease, capable of sustaining durable remissions. Two CAR-T cell products (axicabtagene ciloleucel and tisagenlecleucel) are currently approved by the FDA. A third anti CD 19 CAR-T cell, lisocabtagene ciloleucel is currently being evaluated in large clinical trials and may also be FDA approved. CAR- T cell related toxicities, including infections, cytokine release syndrome and neurotoxicity are potential complications of therapy. Ongoing research aims to improve the safety, efficacy of this therapy. In this review, we will summarize CAR -T cell therapy, their limitations and recent developments.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research

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ConclusionVenetoclax therapy in a real-world cohort offered modest benefits in heavily pretreated patients. Adverse events were observed at a greater incidence than in the clinical trials. A wide heterogeneity of venetoclax dose escalation, multiagent combinations, and timing of initiation were identified and require investigation in subsequent clinical trials.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Shutdowns earlier this year of two facilities that use ethylene oxide (EtO) to sterilize medical devices prompted FDA to monitor for supply shortages in the industry because EtO is such a popular sterilization method for medical devices. This week the agency revealed steps it will take to reduce medtech's reliance on EtO sterilization. EtO is a flammable, colorless gas used to sterilize equipment and plastic devices that cannot be sterilized by steam, such as medical equipment. In fact, about half of all sterilized medical devices undergo sterilization using this gas. Breathi...
Source: MDDI - Category: Medical Devices Authors: Tags: Sterilization Regulatory and Compliance Source Type: news
CONCLUSIONS: Palliative care was provided to a minority of patients with hematologic malignancies and considerable improvement is required in its timely use and extension. PMID: 31714147 [PubMed - as supplied by publisher]
Source: The American Journal of Hospice and Palliative Care - Category: Palliative Care Authors: Tags: Am J Hosp Palliat Care Source Type: research
CONCLUSION: In a real-world setting, the QLQ-C30 summary score has a strong prognostic value for overall survival for a number of populations of patients with cancer above and beyond that provided by clinical and sociodemographic variables. The QLQ-C30 summary score appears to have more prognostic value than the global QoL, physical functioning, or any other scale within the QLQ-C30. IMPLICATIONS FOR PRACTICE: The finding that health-related quality of life provides distinct prognostic information beyond known sociodemographic and clinical measures, not only around cancer diagnosis (baseline) but also at follow-up, ha...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
We describe the recent developments in this field, with emphasis on the complications of therapy and factors contributing to toxicities, efficacy, and resistance. We also describe the ongoing research in this field and the newer CAR-T cell constructs that are being developed to counter the challenges that have been identified in this field.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Adoptive cellular immunotherapy with anti CD19 chimeric antigen receptor (CAR)-T cell has changed the treatment landscape in relapsed/refractory B cell lymphomas. They have emerged as effective therapy in patients with multiple relapsed/refractory disease, capable of sustaining durable remissions. Two CAR-T cell products (axicabtagene ciloleucel and tisagenlecleucel) are currently approved by the United States Food and Drug Administration. A third anti CD19 CAR-T cell, lisocabtagene ciloleucel is currently being evaluated in large clinical trials and may also be United States Food and Drug Administration-approved soon.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Review Source Type: research
Non-Hodgkin lymphomas that are refractory to or relapse after frontline chemoimmunotherapy have a poor prognosis. Although high dose chemotherapy, followed by autologous stem cell transplantation remains the standard of care at relapse, this treatment modality leads to a cure in less than 50% of the patients. Adoptive cellular immunotherapy with anti CD 19 chimeric antigen receptor (CAR) T cell has changed the treatment landscape in B cell lymphomas. They have emerged as effective therapy in patients with multiple relapsed/refractory disease, capable of sustaining durable remissions.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Review Article Source Type: research
ConclusionVenetoclax therapy in a real-world cohort offered modest benefits in heavily-pretreated patients. Adverse events were observed at higher incidence compared to clinical trials. A wide heterogeneity of venetoclax dose escalation, multi-agent combinations, and timing of initiation were identified and would best be investigated in subsequent clinical trials.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 28 September 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Zachary L. Quinn, Karam Zakharia, Janet L. Schmid, John J. Schmieg, Hana Safah, Nakhle S. SabaAbstractPrimary dural diffuse large B-cell lymphoma (PD-DLBCL) is a rare and aggressive B-cell non-Hodgkin lymphoma (NHL) that can present in intracranial or intraspinal locations. While the optimal management is unknown, PD-DLBCL therapy is often mirrored after primary central nervous system lymphoma (PCNSL) therapy and aggressive treatment with a high dose Methotrexate (MTX)-based regimen is frequently used. Our comprehen...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Non-Hodgkin lymphomas (NHL) are a heterogeneous group of diseases which may exhibit aggressive behavior in the relapsed/refractory setting. Venetoclax shows clinical activity in phase I trials for patients with NHL. We investigated 34 patients treated off-study. Outcomes of salvage venetoclax showed a median progression-free survival of 2 months. Challenges of venetoclax therapy in NHL include choice of efficacious combination therapies.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
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