CD19-targeted immunotherapies for treatment of patients with non-Hodgkin B-cell lymphomas. (3rd July 2018)

• Record Type: Journal Article
• Authors: Watkins, Marcus P.; Bartlett, Nancy L.
• Is Part Of: Expert opinion on investigational drugs. Volume 27:Number 7(2018)
• Page Start: 601
• Page End: 611
• Publication Date: 2018-07-03
• Subjects: CD19 -- B cell lymphoma -- CAR-T cells -- blinatumomab -- antibody drug conjugates; Drugs -- Design -- Periodicals; Drugs, Investigational -- Bibliography; Drugs, Investigational -- Periodicals; 615.1
• DOI: 10.1080/13543784.2018.1492549
• Languages: English
• ISSNs: 1354-3784

Abstract

ABSTRACT: Introduction : Ubiquitous expression of CD19 on B cell non-Hodgkin lymphoma identified it as a potential target for immune-based therapies. Areas covered : This article reviews the current literature on anti-CD19 therapies currently in clinical trials including monoclonal antibodies (mAb), antibody targeted cytotoxic drug conjugates (ADC), bispecific antibodies, and chimeric antigen receptor (CAR) modified T cells. Expert opinion : Naked anti-CD19 mAbs have shown little clinical benefit in B cell lymphomas. Despite unusual toxicity profiles with many anti-CD19 ADCs slowing development, durable remissions in a substantial minority of patients with refractory aggressive lymphomas should encourage continued efforts in this area. Blinatumomab, an anti-CD19 bispecific T cell engager, has shown impressive responses in relapse/refractory diffuse large B cell lymphoma (DLBCL), but is plagued by neurotoxicity issues and the need for continuous infusion. CD19 targeting CAR-T cell therapies are the most promising, with the potential for curing a third of refractory DLBCL patients. There is still much work to be done to address potentially life-threatening cytokine release syndrome and neurotoxicity, an extended production time precluding patients with rapidly progressive disease, and treatment expense. However, if the promise of CAR-T cell technology is confirmed, this will likely change the approach and prognosis for relapse/refractory aggressive lymphoma.