Early Off-Study Experience of Chimeric Antigen Receptor T Cells in Aggressive Lymphoma: Closer to a Real-World Setting
Menée aux Etats-Unis dans un contexte de vie réelle auprès de 122 patients atteints d'un lymphome non hodgkinien à cellules B agressif et récidivant, cette étude évalue l'efficacité, du point de vue du taux de réponse, de la durée de la réponse, de la survie sans progression et de la survie globale, et la toxicité de l'axicabtagène ciloleucel (durée médiane de suivi : 10,4 mois)
Chimeric antigen receptor (CAR) T-cell immunotherapy was reported by ASCO in 2018 as the advance of the year. This innovative cancer treatment originated from intensive experimental work in academic research laboratories, and initial phase I trials were pioneered by a few determined clinical investigators.1 Pharmaceutical companies took the challenge of developing CD19-directed CAR T cells as a therapy that could be more widely accessible for a greater number of hospitals to benefit a larger population of patients. They conducted pivotal phase I/II studies that have already brought 2 drugs, axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel), to the market. These CAR T products were approved by health authorities in the United States in October 2017 and May 2018 for the treatment of patients with diffuse large B-cell lymphoma (DLBCL) or other forms of aggressive B-cell lymphoma (transformed follicular lymphoma for either agent, and primary mediastinal large-cell lymphoma for axi-cel only). Tisa-cel was also approved for childhood acute lymphoblastic leukemia. Both drugs were approved in Europe in the summer of 2018, and other CD19-directed CAR T cells are actively being developed (including lisocabtagene maraleucel, which may reach the market soon).
Journal of Clinical Oncology , éditorial, 2019