J Clin Oncol: Human-derived CD19 CAR T cells can provide lasting remission for patients with relapsed or refractory B-ALL

CD19 targeting chimeric antigen receptor (CAR) modified T cells showed unprecedented responses in acute B-lymphocytic leukemia (B-ALL); however, the problem of recurrence is still an important challenge
.
The short duration of CAR T cells is an important risk factor for B-ALL recurrence ; therefore, we urgently need strategies to improve the persistence of CAR T cells

Myers and other researchers conducted a clinical trial flight, recruited 72 patients with recurrent / refractory B-ALL and 2 patients with recurrent refractory B / cell lymphoma child and young adult patients, and whether based on past Those who had received CAR treatment were divided into two cohorts: the retreatment group (n=33) and the CAR initial treatment group (n=41), and were treated with human-derived CD19 CAR T cells (huCART19)
.
Monitor toxicity, treatment response and persistence of huCART19

All 74 patients (1-29 years old) received huCART19 treatment
.
Sixty-two (84%) patients developed cytokine release syndrome, of which 5 cases (6.

RFS, EFS and OS in newly treated and retreated patients

In the CAR initial treatment cohort, the overall response rate after one month of infusion of huCART19 was as high as 98% (100% in B-ALL patients) ; in the retreatment cohort, the response rate was 64%
.
At 6 months, the persistent loss rate of huCART19 in CAR initial treatment and retreatment patients was 27% (95% CI 14-41) and 48% (30-64), respectively, while the recovery rate of B cells was 15%, respectively (95%CI 6-20) and 58% (33-77)

The recurrence-free survival rates at 12 months and 24 months in the CAR initial treatment cohort were 84% (95% CI 72-97) and 74% (60-90), respectively; at 12 months and 24 months in the retreatment cohort The recurrence-free survival rates were 74% (95% CI 56-97) and 58% (37-90), respectively

Myers Regina M,Li Yimei,Barz Leahy Allison et al.