EHA-SWG 2017 | Rare Lymphomas: CAR T-cells in Non-Hodgkin Lymphoma

On March 12^th, at the EHA-SWG Rare Lymphomas Scientific Meeting 2017 in Barcelona, Spain, Marie José Kersten chaired a scientific session on ‘Fighting Lymphoma with T-cells’. The first presentation of this session was by Catherine Bollard, from The George Washington University, School of Medicine and Health Sciences, Bethesda, USA, on the topic of ‘CD19 CAR T-cells for Lymphoma’. Below are the key highlights from this presentation:

• Over 15 studies open using CAR CD19-transduced T-cells in the US
• First generation CAR T-cells had low persistence in patients
• Second generation CARs developed which include an additional domain, either:
  • CD28
  • 41BBL
  • OX40L
• Second generation CAR T-cell therapy shown to have increased proliferation and persistence vs. first generation within the same B-cell lymphoma patients
• Multiple companies are currently working on different second-generation CAR constructs e.g. Kite, Novartis, Juno, and Bluebird Bio
• Persistence of CAR T-cells correlated with response
• Pre-CAR T-cell lymphodepleting chemotherapy with fludarabine and cyclophosphamide improves CAR T-cell proliferation and persistence
• Cytokine release syndrome remains an important adverse event to monitor and manage in patients undergoing CAR T-cell therapy

To summarize, Catherine Bollard presented data detailing the differences between first and second-generation CAR T-cell technology, outlined the perceived importance of CAR T-cell persistence, identified the main CAR T-cell constructs currently being used, and outlined potential issues in the applicability of this treatment. Studies are ongoing, and long-term follow-up data is eagerly being awaited.