Relapsed or refractory large B-cell lymphoma after chimeric antigen receptor T-cell therapy: Current challenges and therapeutic options.
Raul Del Toro-MijaresOlalekan OluwoleReena V JayaniAdetola A KassimBipin N SavaniBhagirathbhai R DholariaPublished in: British journal of haematology (2023)
Chimeric antigen receptor (CAR) T-cell (CAR-T) therapy can provide durable remission in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after failure of chemoimmunotherapy. However, patients who are refractory or relapsing after CAR-T therapy have poor outcomes. Multiple mechanisms of CAR-T therapy failure have been proposed but management of these patients remains a challenge. As CAR-T therapy moves earlier in the treatment of DLBCL, we urgently need trials focused on patients with relapse after CAR-T therapy. Recent advances in novel immunotherapies such as bispecific antibodies, antibody-drug conjugates and next-generation CAR-T therapies may provide avenues for treatment. Here we review the available data on using these drugs after failure of CAR-T therapy and provide a framework for the ideal sequencing of these novel agents.
Keyphrases
- diffuse large b cell lymphoma
- end stage renal disease
- chronic kidney disease
- epstein barr virus
- ejection fraction
- acute lymphoblastic leukemia
- acute myeloid leukemia
- newly diagnosed
- multiple sclerosis
- stem cells
- metabolic syndrome
- single cell
- drug delivery
- adipose tissue
- machine learning
- rheumatoid arthritis
- multiple myeloma
- electronic health record
- big data
- data analysis