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Inicio Medicina Clínica (English Edition) Chimeric antigen receptor T-cell (CAR-T) therapy in patients with aggressive B-c...
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Vol. 158. Issue 7.
Pages 327-332 (April 2022)
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Vol. 158. Issue 7.
Pages 327-332 (April 2022)
Review
Chimeric antigen receptor T-cell (CAR-T) therapy in patients with aggressive B-cell lymphomas. Current outlook after a decade of treatment
Terapia con linfocitos T con receptor de antígeno quimérico (CAR-T) en pacientes con linfoma de célula B agresivos. Perspectiva actual tras una década de tratamiento
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Eva Cataláa, Gloria Iacobonia,b,c, Pere Barbaa,b,c,
Corresponding author
pbarba@vhio.net

Corresponding author.
a Department of Hematology, University Hospital Vall d'Hebron, Barcelona, Spain
b Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
c Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Table 1. Pivotal studies in aggressive non-Hodgkin's lymphomas with CAR T-cells.
Table 2. Published real life studies with CAR T-cells.
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Abstract

Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the management of patients with diffuse large B-cell lymphoma (DLBCL) who are refractory or relapse after immunochemotherapy. This strategy consists in genetically modifying the patient's own T lymphocytes to favor the recognition of selected tumor antigens. Currently, we have 2 anti-CD19 CAR-T drugs approved in Spain for patients with DLBCL after 2 or more prior treatment lines and there are multiple ongoing clinical trials exploring earlier lines of treatment. Both clinical trials and post-marketing real-world data have contributed to better define the efficacy and safety profile of each construct, identifying the main prognostic response factors and improving the management of each step in this therapy. All these aspects are reviewed herein.

Keywords:
Diffuse large B-cell lymphoma
Chimeric antigen receptor T-cells
Clinical trial
Resumen

La terapia con linfocitos T con receptor de antígeno quimérico (CAR-T) ha revolucionado el manejo de los pacientes con linfoma difuso de células grandes B (LDCGB) refractarios o en recaída tras inmunoquimioterapia. Esta estrategia consiste en modificar genéticamente los linfocitos T de los propios pacientes para favorecer el reconocimiento de los antígenos tumorales seleccionados. Actualmente hay disponibles 2 medicamentos CAR-T anti-CD19 aprobados en España para pacientes con LDCGB tras 2 o más líneas de tratamiento sistémico previo y existen múltiples ensayos clínicos en marcha investigando su uso en líneas de tratamiento más precoces. Tanto los ensayos clínicos pivotales como los datos de práctica asistencial post-comercialización han contribuido a definir el perfil de eficacia y seguridad de cada constructo, identificar los principales factores pronósticos de respuesta y optimizar el manejo de las distintas fases de esta terapia. Todos estos aspectos se repasan en esta revisión.

Palabras clave:
Linfoma difuso de células grandes B
Linfocitos T con receptor de antígeno quimérico
Ensayo clínico

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