The use of chimeric antigen receptor T cells in patients with non-Hodgkin lymphoma

Clin Adv Hematol Oncol. 2018 May;16(5):375-386.

Abstract

Resistance to conventional lines of therapy develops in approximately 20% of all patients with lymphoma. These patients have a dismal prognosis, with an expected median survival of 6.3 months. In recent years, T-cell immunotherapy has demonstrated a remarkable capacity to induce complete and durable clinical responses in patients with chemotherapy-refractory lymphoma. A major contributor to the success of immunotherapy has been the advent of genetic engineering technologies that introduce a chimeric antigen receptor (CAR) into T cells to focus their killing activity on tumor cells. The adoptive transfer of autologous CAR T-cell products specific for the pan-B-cell antigen CD19 have now received approval from the US Food and Drug Administration (FDA) for the treatment of relapsed or chemotherapy-resistant B-cell non-Hodgkin lymphoma. This review is designed to showcase the clinical efficacy and unique toxicities of individually developed CAR T-cell products for the treatment of lymphomas and their evolution from the laboratory bench to commercialization.

Publication types

  • Review

MeSH terms

  • Antigens, CD19 / genetics
  • Antigens, CD19 / immunology*
  • Antineoplastic Agents / therapeutic use
  • Clinical Trials as Topic
  • Drug Resistance, Neoplasm / immunology
  • Genetic Vectors / immunology
  • Genetic Vectors / metabolism
  • Humans
  • Immunotherapy, Adoptive / methods*
  • Lentivirus / genetics
  • Lentivirus / immunology
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / immunology
  • Lymphoma, Non-Hodgkin / mortality
  • Lymphoma, Non-Hodgkin / therapy*
  • Plasmids / immunology
  • Plasmids / metabolism
  • Prognosis
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Antigen, T-Cell / immunology*
  • Recombinant Fusion Proteins / genetics
  • Recombinant Fusion Proteins / immunology*
  • Survival Analysis
  • T-Lymphocytes, Cytotoxic / cytology
  • T-Lymphocytes, Cytotoxic / immunology*
  • T-Lymphocytes, Cytotoxic / transplantation
  • Treatment Outcome

Substances

  • Antigens, CD19
  • Antineoplastic Agents
  • CD19 molecule, human
  • Receptors, Antigen, T-Cell
  • Recombinant Fusion Proteins