Axicabtagene Ciloleucel: Clinical Data for the Use of CAR T-cell Therapy in Relapsed and Refractory Large B-cell Lymphoma.

The Annals of Pharmacotherapy
Zachery HalfordLunawati L Bennett

Abstract

To evaluate the literature for axicabtagene ciloleucel (axi-cel), a first-in-class chimeric antigen receptor (CAR) T-cell therapy, in the treatment of relapsed/refractory (r/r) large B-cell lymphoma (LBCL). We conducted a PubMed (inception to June 22, 2020) and ClinicalTrials.gov search using the following terms: CD19, chimeric antigen receptor, and lymphoma. All retrospective and prospective studies evaluating the use of axi-cel in LBCL were reviewed. In the pivotal ZUMA-1 trial, axi-cel exhibited unprecedented overall and complete response rates of 83% and 58%, respectively. With a median follow-up of 27.1 months, 39% of patients had ongoing responses. Furthermore, postmarketing retrospective analyses found similar response rates in a more clinically diverse LBCL patient population. Novel CAR T-cell therapy elicits unique and potentially life-threatening toxicities that include cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Studies reported grade ≥3 CRS in 7% to 14% of patients and grade ≥3 ICANS in 31% to 55% of patients. Axi-cel was the first US Food and Drug Administration-approved genetically engineered autologous CAR T-cell agent in r/r LBCL, representing an important ...Continue Reading

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Citations

May 17, 2021·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Veronique F KugenerMaxine Gossell-Williams
Aug 14, 2021·ImmunoTargets and Therapy·Reyisa BughdaAstero Klampatsa
Sep 14, 2021·The Cochrane Database of Systematic Reviews·Moritz ErnstMarius Goldkuhle

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Methods Mentioned

BETA
genetic modifications
leukapheresis

Clinical Trials Mentioned

NCT00924326
NCT02348216
NCT02445248
NCT02631044
NCT03391466
NCT02926833
NCT02601313
NCT02614066
NCT02625480
NCT03624036

Software Mentioned

axi
cel

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