Real-World Insights into CAR T-Cell Therapy: Efficacy and Safety of Kymriah in B-ALL and NHL
Harish Jaiswal 1*, Aayush Vaishnaw 1
Journal of Angiotherapy 8(9) 1-7 https://doi.org/10.25163/angiotherapy.899889
Submitted: 08 July 2024 Revised: 09 September 2024 Published: 11 September 2024
This study provides extensive real-world data on Kymriah's efficacy and safety, revealing valuable insights into its use in B-ALL and NHL.
Abstract
Background: Chimeric Antigen Receptor (CAR) T-cell therapy has emerged as a revolutionary treatment for certain cancers, particularly B-cell malignancies. This study focused on the real-world outcomes of Kymriah (tisagenlecleucel), a CAR T-cell therapy targeting CD19, by analyzing data from the Cellular Immunotherapy Data Resource (CIDR). A total of 410 patients with relapsed or refractory B-cell Acute Lymphoblastic Leukemia (B-ALL) and Non-Hodgkin Lymphoma (NHL) were included. Methods: Data were collected from 73 treatment centers across the U.S. and Canada. Key outcomes measured included Cytokine Release Syndrome (CRS), Immune-effector Cell-Associated Neurotoxicity Syndrome (ICANS), overall response rate (ORR), duration of response (DOR), and survival rates. Statistical analyses were performed using descriptive statistics, Kaplan-Meier methods, and logistic regression. Results: CRS was observed in 54.3% of B-ALL patients, with severe cases in 16.1%. The complete remission rate in B-ALL patients was 85.5%, with a 12-month overall survival rate of 76.4%. In NHL patients, the overall response rate was 62.4%, with 38.2% achieving complete remission. Severe CRS and ICANS were less frequent in NHL patients. Conclusion: Kymriah demonstrated high efficacy in both B-ALL and NHL, with manageable side effects. However, ongoing monitoring is essential to optimize outcomes and reduce adverse events. This study provides valuable real-world data, contributing to the growing understanding of CAR T-cell therapy’s potential in clinical practice.
Keywords: CAR T-cell therapy, Kymriah, B-cell acute lymphoblastic leukemia, Cytokine release syndrome, Non-Hodgkin lymphoma
References
Alamer, L., Alqahtani, I. M., & Shadadi, E. (2023). Intelligent health risk and disease prediction using optimized Naive Bayes classifier. Journal of Internet Services and Information Security, 13(1), 01-10.
Awasthi, R., Maier, H. J., Zhang, J., & Lim, S. (2023). Kymriah® (tisagenlecleucel) – an overview of the clinical development journey of the first approved CAR-T therapy. Human Vaccines & Immunotherapeutics, 19(1), 2210046.
D'Souza, A., Fretham, C., Lee, S. J., Arora, M., Brunner, J., Chhabra, S., ... & Horowitz, M. M. (2020). Current use of and trends in hematopoietic cell transplantation in the United States. Biology of Blood and Marrow Transplantation, 26(8), e177-e182.
Fallati, A., Di Marzo, N., D’Amico, G., & Dander, E. (2022). Mesenchymal stromal cells (MSCs): An ally of B-cell acute lymphoblastic leukemia (B-ALL) cells in disease maintenance and progression within the bone marrow hematopoietic niche. Cancers, 14(14), 3303.
Guarini, A., Radice, G., Peragine, N., Buracchi, C., De Propris, M. S., Di Rocco, A., ... & Foà, R. (2023). Long-term host immune modulation following tisagenlecleucel administration in patients with diffuse large B-cell lymphoma and B-Lineage acute lymphoblastic leukemia. Cancers, 15(9), 2411.
Qu, J., Mei, Q., Chen, L., & Zhou, J. (2021). Chimeric antigen receptor (CAR)-T-cell therapy in non-small-cell lung cancer (NSCLC): Current status and future perspectives. Cancer Immunology, Immunotherapy, 70, 619-631.
Que, Y., Hu, C., Wan, K., Hu, P., Wang, R., Luo, J., & Xu, G. (2022). Cytokine release syndrome in COVID-19: A major mechanism of morbidity and mortality. International Reviews of Immunology, 41(2), 217-230.
Ramakrishnan, J., Ravi Sankar, G., & Thavamani, K. (2019). Publication growth and research in India on lung cancer literature: A bibliometric study. Indian Journal of Information Sources and Services, 9(S1), 44-47.
Wu, W., Zhou, Q., Masubuchi, T., Shi, X., Li, H., Xu, X., & Xu, C. (2020). Multiple signaling roles of CD3ε and its application in CAR-T cell therapy. Cell, 182(4), 855-871.
Zhang, Y., Ge, T., Huang, M., Qin, Y., Liu, T., Mu, W., ... & Wang, J. (2023). Extracellular vesicles expressing CD19 antigen improve expansion and efficacy of CD19-targeted CAR-T cells. International Journal of Nanomedicine, 49-63.
Zinter, M. S., Logan, B. R., Fretham, C., Sapru, A., Abraham, A., Aljurf, M. D., ... & Dvorak, C. C. (2020). Comprehensive prognostication in critically ill pediatric hematopoietic cell transplant patients: Results from merging the Center for International Blood and Marrow Transplant Research (CIBMTR) and Virtual Pediatric Systems (VPS) registries. Biology of Blood and Marrow Transplantation, 26(2), 333-342.
View Dimensions
View Altmetric
Save
Citation
View
Share