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- W4361946551 abstract "<div>AbstractPurpose:<p>The chimeric antigen receptor (CAR) T-cell therapy has been effective for patients with CD19<sup>+</sup> B-cell malignancies. Most studies have investigated the second-generation CARs with either CD28 or 4-1BB costimulatory domains in the CAR receptor. Here, we describe the first clinical phase I/IIa trial using third-generation CAR T cells targeting CD19 to evaluate safety and efficacy.</p>Patients and Methods:<p>Fifteen patients with B-cell lymphoma or leukemia were treated with CAR T cells. The patients with lymphoma received chemotherapy during CAR manufacture and 11 of 15 were given low-dose cyclophosphamide and fludarabine conditioning prior to CAR infusion. Peripheral blood was sampled before and at multiple time points after CAR infusion to evaluate the persistence of CAR T cells and for immune profiling, using quantitative PCR, flow cytometry, and a proteomic array.</p>Results:<p>Treatment with third-generation CAR T cells was generally safe with 4 patients requiring hospitalization due to adverse reactions. Six of the 15 patients had initial complete responses [4/11 lymphoma and 2/4 acute lymphoblastic leukemia (ALL)], and 3 of the patients with lymphoma were in remission at 3 months. Two patients are still alive. Best predictor of response was a good immune status prior to CAR infusion with high IL12, DC-Lamp, Fas ligand, and TRAIL. Responding patients had low monocytic myeloid-derived suppressor cells (MDSCs; CD14<sup>+</sup>CD33<sup>+</sup>HLA<sup>−</sup>DR<sup>−</sup>) and low levels of IL6, IL8, NAP3, sPDL1, and sPDL2.</p>Conclusions:<p>Third-generation CARs may be efficient in patients with advanced B-cell lymphoproliferative malignancy with only modest toxicity. Immune profiling pre- and posttreatment can be used to find response biomarkers.</p></div>" @default.
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- W4361946551 date "2023-03-31" @default.
- W4361946551 modified "2023-10-14" @default.
- W4361946551 title "Data from A Phase I/IIa Trial Using CD19-Targeted Third-Generation CAR T Cells for Lymphoma and Leukemia" @default.
- W4361946551 doi "https://doi.org/10.1158/1078-0432.c.6526845" @default.
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