TY - JOUR
T1 - Preparing for CAR T cell therapy
T2 - patient selection, bridging therapies and lymphodepletion
AU - Amini, Leila
AU - Silbert, Sara K.
AU - Maude, Shannon L.
AU - Nastoupil, Loretta J.
AU - Ramos, Carlos A.
AU - Brentjens, Renier J.
AU - Sauter, Craig S.
AU - Shah, Nirali N.
AU - Abou-el-Enein, Mohamed
N1 - Publisher Copyright:
© 2022, Springer Nature Limited.
PY - 2022/5
Y1 - 2022/5
N2 - Chimeric antigen receptor (CAR) T cells have emerged as a potent therapeutic approach for patients with certain haematological cancers, with multiple CAR T cell products currently approved by the FDA for those with relapsed and/or refractory B cell malignancies. However, in order to derive the desired level of effectiveness, patients need to successfully receive the CAR T cell infusion in a timely fashion. This process entails apheresis of the patient’s T cells, followed by CAR T cell manufacture. While awaiting infusion at an authorized treatment centre, patients may receive interim disease-directed therapy. Most patients will also receive a course of pre-CAR T cell lymphodepletion, which has emerged as an important factor in enabling durable responses. The time between apheresis and CAR T cell infusion is often not a simple journey, with each milestone being a critical step that can have important downstream consequences for the ability to receive the infusion and the strength of clinical responses. In this Review, we provide a summary of the many considerations for preparing patients with B cell non-Hodgkin lymphoma or acute lymphoblastic leukaemia for CAR T cell therapy, and outline current limitations and areas for future research.
AB - Chimeric antigen receptor (CAR) T cells have emerged as a potent therapeutic approach for patients with certain haematological cancers, with multiple CAR T cell products currently approved by the FDA for those with relapsed and/or refractory B cell malignancies. However, in order to derive the desired level of effectiveness, patients need to successfully receive the CAR T cell infusion in a timely fashion. This process entails apheresis of the patient’s T cells, followed by CAR T cell manufacture. While awaiting infusion at an authorized treatment centre, patients may receive interim disease-directed therapy. Most patients will also receive a course of pre-CAR T cell lymphodepletion, which has emerged as an important factor in enabling durable responses. The time between apheresis and CAR T cell infusion is often not a simple journey, with each milestone being a critical step that can have important downstream consequences for the ability to receive the infusion and the strength of clinical responses. In this Review, we provide a summary of the many considerations for preparing patients with B cell non-Hodgkin lymphoma or acute lymphoblastic leukaemia for CAR T cell therapy, and outline current limitations and areas for future research.
UR - http://www.scopus.com/inward/record.url?scp=85126897025&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126897025&partnerID=8YFLogxK
U2 - 10.1038/s41571-022-00607-3
DO - 10.1038/s41571-022-00607-3
M3 - Review article
C2 - 35318469
AN - SCOPUS:85126897025
SN - 1759-4774
VL - 19
SP - 342
EP - 355
JO - Nature Reviews Clinical Oncology
JF - Nature Reviews Clinical Oncology
IS - 5
ER -