Lisocabtagene maraleucel for relapsed or refractory large B-cell non-Hodgkin lymphoma

Abstract

ABSTRACT Introduction Chimeric antigen receptor T (CAR T) cell therapy epitomizes the success of T cell engineering. Today, it is an integral component of the treatment algorithm for various types of B-cell non-Hodgkin lymphoma (NHL). Large B-cell lymphoma (LBCL) is the most common subtype of NHL accounting for 30–35% of cases. A lack of response to second-line therapy portends a poor prognosis as only 7–15% of patients attain complete remission (CR) with subsequent conventional chemoimmunotherapy. Areas covered Lisocabtagene maraleucel (liso-cel) is an autologous CD-19 directed CAR T-cell product with a 4–1BB co-stimulatory domain administered as a sequential infusion of 2 separately manufactured components: CD8+ and CD4+ CAR T-cells in equal doses. Liso-cel showed an impressive objective response rate of 73% (CR = 53%) in patients who had received a median of 3 prior therapies. Median time-to-first CR or partial response (PR) was 1 month. Expert opinion When evaluated in the second line setting in LBCL, liso-cel demonstrated superior event-free survival (EFS) versus standard of care. While acknowledging that choice of a particular CAR T-cell is based chiefly on familiarity of the treating physician with a specific product, liso-cel definitely represents an important addition to the treatment armamentarium of R/R LBCL whether in the second-line setting or beyond.