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Yescarta - new hope for patients with relapsed diffuse large-cell lymphoma?

Publication at First Faculty of Medicine |
2019

Abstract

B-cell non-Hodgkin lymphomas (B-NHL) represent the most common hematological malignancy of adulthood. Despite extensive efforts and advanced research, the (R-)CHOP chemotherapy regimen has been a therapy standard for decades.

However, in some patients, the disease is refractory to this standard treatment or it relapses early, worsening their prognosis dramatically. Thus, great attention is paid to new treatment options, especially the use of immunotherapy.

One of the most promising discoveries is the CD19-specific T-lymphocytes with chimeric antigen receptor (CAR T). Axicabtagene ciloleucel is one of the first FDA approved products, prepared from autologous T-lymphocytes.

Its effectiveness against refractory or relapsed B-NHL has been demonstrated in Phase I and II of the ZUMA-1 trial, in which more than half of the patients achieved complete remission (58%; overall response 83%), which is unprecedented success compared to the historical cohort with the same diagnosis. Moreover, 39% of patients remained in remission after two years of follow-up observation.

These favorable data were also confirmed "in real world" by retrospective analyses of several patients' cohorts treated with axicabtagene ciloleucel after its approval by the FDA.