Title:Chimeric Antigen Receptor-Engineered T-Cells - A New Way and Era for Lymphoma Treatment
VOLUME: 14 ISSUE: 4
Author(s):Romeo G. Mihăilă*
Affiliation:“Lucian Blaga” University of Sibiu, Faculty of Medicine, Emergency County Clinical Hospital Sibiu, Sibiu 550169
Keywords:Axicabtagene ciloleucel, chimeric antigen receptor, cytokine release syndrome, diffuse large B-cell lymphoma,
tisagenlecleucel, tocilizumab.
Abstract:
Background: Patients with refractory or relapsed diffuse large B-cell lymphoma have a poor
prognosis with the current standard of care.
Objective: Chimeric Antigen Receptor T-cells (CAR T-cells) are functionally reprogrammed lymphocytes,
which are able to recognize and kill tumor cells. The aim of this study is to make progress in this
area.
Methods: A mini-review was achieved using the articles published in Web of Science and PubMed in
the last year and the new patents were made in this field.
Results: The responses to CAR T-cell products axicabtagene ciloleucel and tisagenlecleucel are promising;
the objective response rate can reach up to 83%, and the complete response rate ranges between
40 and 58%. About half of the patients may have serious side effects, such as cytokine release syndrome
and neurotoxicity. Current and future developments include the improvement of CAR T-cell
expansion and polyfunctionality, the combined use of CAR T-cells with a fusion protein between interferon
and an anti-CD20 monoclonal antibody, with checkpoint inhibitors or small molecule sensitizers
that have apoptotic-regulatory effects. Furthermore, the use of IL-12-expressing CAR T-cells, an improved
technology for the production of CAR T-cells based on targeted nucleases, the widespread use
of allogeneic CAR T-cells or universal CAR T-cells obtained from genetically engineered healthy donor
T-cells are future developments actively considered.
Conclusion: CAR T-cell therapy significantly improved the outcome of patients with relapsed or refractory
diffuse large B-cell lymphoma. The advances in CAR T-cells production technology will improve
the results and enable the expansion of this new immunotherapy.
