CAR T-Cell Therapy With TanCAR7 Demonstrates Efficacy in DLBCL

Some 70% of recurrent/refractory (R/R) non-Hodgkin lymphoma (NHL) patients treated with tandem CD19/CD20 chimeric antigen receptor (CAR) T-cell therapy experienced a complete response (CR), findings from a single-arm phase 1/2 trial suggest.

“We found that T cells with a TanCAR7 structure possessed robust antitumor activity in vitro, and we showed early evidence of the safety and efficacy of TanCAR7 T cells in R/R NHL treatment,” explained lead author Yajing Zhang, Chinese PLA General Hospital, Beijing, and co-investigators.

In the study, which was conducted from May 2017 to January 2020 in China, 87 patients with R/R NHL received an infusion at doses of 0.5 × 10⁶–8 × 10⁶ TanCAR7 T cells per kg of body weight after conditioning chemotherapy. The first 28 patients in the interim report were followed up for an extended time, and an extension cohort was recruited. The researchers combined the 2 patient cohorts and presented the updated analysis. The data cut-off date for the efficacy evaluation was March 2021.

All patients were diagnosed with NHL, including 58 with diffuse large B-cell lymphoma (DLBCL, 67%), 13 with follicular lymphoma (FL, 15%), 6 with transformed follicular lymphoma (t-FL, 7%), 5 with primary mediastinal B-cell lymphoma (PMBCL, 6%), 2 with chronic lymphocytic leukemia and small lymphocytic lymphoma (CLL and SLL, 2%), 2 with mantle-cell lymphoma (MCL, 2%), and 1 with mucosa-associated lymphoid tissue lymphoma (MALT, 1%). Of the cohort, 58 patients had aggressive diffuse large B-cell lymphoma and 24 had high tumor burden.

The best overall response rate (ORR) was 78% (95% confidence interval [CI], 68–86); response rates were consistent across prognostic subgroups. The median progression-free survival (PFS) was 27.6 months (95% CI, 11-NR). With a median follow-up of 27.7 months, 60% of the patients remained in remission.

Two patients died from treatment-associated severe pulmonary infection, and 1 died from cytokine release syndrome (CRS)-related pulmonary infection associated with persistent unrecoverable myelosuppression at 1.5 months post-infusion. CRS occurred in 61 patients (70%), with 60% of cases being grade 1 or 2, and 10% being grade 3 or greater. Grade 3 CAR T-cell-related encephalopathy syndrome occurred in 2 patients (2%).

Source:
Zhang Y, Wang Y, Liu Y, et al. Long-term activity of tandem CD19/CD20 CAR therapy in refractory/relapsed B-cell lymphoma: a single-arm, phase 1–2 trial. Leukemia (2022) 36:189–196