05.19.22

HuCART-19 Plus Ibrutinib Treatment in CLL

Gill SI, Frey NV, Hexner E, et al. Anti-CD19 CAR T Cells in Combination with Ibrutinib for the Treatment of Chronic Lymphocytic Leukemia. Blood Advances. 2022; (doi: 10.1182/bloodadvances.2022007317).

For patients with chronic lymphocyte leukemia (CLL) not in complete remission (CR), autologous anti-CD19 humanized binding domain T cells (huCART-19) administered in conjunction with the Bruton's tyrosine kinase inhibitor ibrutinib induces durable remissions. Researchers undertook a prospective single-center phase II trial involving CLL patients not in CR despite at least 6 months of ibrutinib. Nineteen of 20 enrolled patients received huCART-19, with a median follow-up of 41 months. Cytokine release syndrome — primarily grade 1-2 — occurred in 18 patients, while neurotoxicity developed in five, also mostly grade 1-2. At 3 months, the CR rate among International Working Group on CLL-evaluable patients was 44%; however, no measurable residual disease was detected in 72% of patients at 12 months. Overall survival at 48 months was 84%, and progression-free survival was 70%. At the last follow-up, 13 of 15 patients with undetectable MRD at 3 or 6 months were still in CR, the researchers report.

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