CD19-directed chimeric antigen receptor (CAR) T-cell therapy may be effective treatment for primary central nervous system (CNS) lymphoma, according to a case series published in Blood Advances.
CD19 CAR T cells have been used to treat B-cell malignancies with good responses but have not been evaluated in patients with CNS lymphoma. The CAR T cells can be detected in cerebrospinal fluid, which suggests they could migrate into the CNS. Patients with secondary CNS lymphoma have been included in some trials.
The authors reported on a case series of 5 patients with primary CNS lymphoma treated with CD19 CAR T cells as part of a phase 1 clinical trial (NCT02153580). At 28 days after infusion, 3 of 5 patients (60%) appeared to have complete remission (CR). CR was based on complete resolution of enhancing lesion on MRI. The other 2 patients had stable disease.
Blood collection in 4 patients at 28 days postinfusion showed CAR T-cell expansion and the absence of CD19+ B cells or systemic lymphoma.
Despite the small study size, CD19 CAR T cells showed promise in treating primary CNS lymphoma with tolerable side effects. A total of 3 of 5 patients had clinical improvement, and 1 had a durable response.
The data support further investigation of CD19 CAR T cells in this patient population.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Siddiqi T, Wang X, Blanchard MS, et al. CD19-directed CAR T-cell therapy for treatment of primary CNS lymphoma. Blood Adv. 2021;5(20):4059-4063. doi:10.1182/bloodadvances.2020004106