CAR T cells have already changed the treatment paradigm for recurrent and resistant DLBCL, which, as shown in the SCHOLAR-I study, has a dismal prognosis with conventional therapy, with a response rate of 26%, a 7% rate of complete response and median survival of just over 6 months. In contrast, three studies with CAR T cells have shown response rates of 59% to 88%, with about half of patients achieving a complete response and an estimated 40% of patients disease-free and possibly cured at 1 to 2 years after treatment. Even though the latter results are probably slightly inflated because the response and survival data were based on patients who received the product as opposed to the intent-to-treat population, the results appear much better than with conventional treatment. Although the often-described toxicity was considerable, it was generally limited to the month after treatment. Further, mortality was low, and morbidity was considerably less than after allogeneic transplant, a strategy often considered in this patient population.
This activity is supported by an educational grant from Global Blood Therapeutics.
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