Second CD19-targeted CAR T-cell infusion for R/R B-cell malignancies

CD19 CAR T-cells are transforming the treatment of relapsed or refractory (R/R) B-cell malignancies. However, complete responses are not seen in all patients, and in a significant proportion, these responses are not durable. Jordan Gauthier, MD, MSc, Fred Hutchinson Cancer Research Center, Seattle, WA, discusses second infusions of CD19 CAR T-cells (CART2) as a possible approach to improve outcomes in patients with R/R B-cell malignancies. An analysis of the outcomes after CART2 in patients with R/R acute lymphoblastic leukemia, non-Hodgkin lymphoma, and chronic lymphocytic leukemia treated on a Phase I/II clinical trial of CD19 CAR T-cells of defined composition showed that CART2 was feasible and safe in most patients. Additionally, two modifiable pre-treatment factors independently associated with better outcomes after CART2 were identified. This interview took place during the 3rd European CAR T-cell Meeting.