From the Research
Currently, there is no FDA-approved CAR-T cell therapy specifically for chronic lymphocytic leukemia (CLL), but clinical trials are investigating several CAR-T candidates, primarily targeting CD19, which is expressed on CLL cells. While CAR-T therapies like Kymriah (tisagenlecleucel), Yescarta (axicabtagene ciloleucel), and Breyanzi (lisocabtagene maraleucel) are approved for certain lymphomas and acute lymphoblastic leukemia, they are not yet approved for CLL 1, 2, 3, 4, 5. Some key points to consider include:
- The most promising results in trials have been seen with CD19-directed CAR-T cells, showing overall response rates of 70-90% in heavily pretreated CLL patients, though durability remains a challenge.
- Patients should discuss with their hematologist-oncologist about clinical trial eligibility, as CAR-T therapy involves lymphodepletion chemotherapy followed by infusion of the engineered T cells, with potential for cytokine release syndrome and neurotoxicity as side effects.
- For patients with relapsed/refractory CLL who have exhausted standard treatments like BTK inhibitors and venetoclax, enrollment in a clinical trial for CAR-T therapy may be an option.
- The use of tisagenlecleucel, a CD19-targeted CAR T-cell therapy, has shown significant efficacy in patients with relapsed/refractory large B-cell lymphoma, with a manageable safety profile and durable complete responses 4.
- The successful utilization of tisagenlecleucel therapy requires meticulous planning, prudent patient selection, multidisciplinary collaboration, and expert training to ensure optimal patient care 5.