Skip to main content

Chimeric Antigen Receptor T Cells for Lymphomas: Methods, Data, and Challenges

  • Chapter
  • First Online:
  • 1066 Accesses

Abstract

Antigen 16 (CD19) is an optimal target for targeted cellular therapy against all B-cell non-Hodgkin lymphomas (B-NHL)/chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and B-cell acute lymphoblastic leukemia (B-ALL). However, targeting CD19 can result in prolonged B-cell aplasia. Given the clinical experience with the anti-CD20 monoclonal antibody rituximab with temporary B-cell aplasia, severe clinical consequence has not been observed. Intravenous gamma globulin has proven to effectively supplement humoral immunity in hypogammaglobulinemic patients. Genetically engineered recombinant T-cell receptors directed against a specific tumor antigen (chimeric antigen receptors, CARs) can recognize and kill tumor cell targets. This review will focus on the clinical experience of targeting CD19 with CAR-modified T cells (19-CAR-T) for B-cell lymphomas, excluding CLL/SLL and multiple myeloma which are covered in other chapters of this book.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Abate-Daga D, Hanada K, Davis JL et al (2013) Expression profiling of TCR-engineered T cells demonstrates overexpression of multiple inhibitory receptors in persisting lymphocytes. Blood 122:1399–1410

    Article  CAS  Google Scholar 

  • Abramson JSPM, Gordon LI, Lunning MA, Arnason JE, Wang M, Forero A, Maloney DG, Albertson T, Garcia J, Li D, Xie B, Siddiqi T (2017) High durable CR rates in relapsed/refractory (R/R) aggressive B-NHL treated with the CD19-directed CAR T cell product JCAR017 (TRANSCEND NHL 001): defined composition allows for dose-finding and definition of pivotal cohort. Blood 130(Suppl 1):581

    Google Scholar 

  • Barrington SF, Mikhaeel NG, Kostakoglu L et al (2014) Role of imaging in the staging and response assessment of lymphoma: consensus of the international conference on malignant lymphomas imaging working group. J Clin Oncol 32:3048–3058

    Article  Google Scholar 

  • Brentjens RJ, Latouche JB, Santos E et al (2003) Eradication of systemic B-cell tumors by genetically targeted human T lymphocytes co-stimulated by CD80 and interleukin-15. Nat Med 9:279–286

    Article  CAS  Google Scholar 

  • Brudno JN, Somerville RP, Shi V et al (2016) Allogeneic T cells that express an anti-CD19 chimeric antigen receptor induce remissions of B-cell malignancies that progress after allogeneic hematopoietic stem-cell transplantation without causing graft-versus-host disease. J Clin Oncol 34:1112–1121

    Article  CAS  Google Scholar 

  • Chang YJ, Huang XJ (2013) Donor lymphocyte infusions for relapse after allogeneic transplantation: when, if and for whom? Blood Rev 27:55–62

    Article  CAS  Google Scholar 

  • Chang LJ, Dong L, Zhu J, Ying Z, Kuo HH, Liu Y, Song YQ, Wang XP, Jia YQ, Niu T, Liu T, Pan L, Liu ZG, Li T, Li YC, Yao K, Ke X, Jing H, Bao F (2015) 4SCAR19 chimeric antigen receptor-modified T cells as a breakthrough therapy for highly chemotherapy-resistant late-stage B cell lymphoma patients with bulky tumor mass. Blood 126:264

    Google Scholar 

  • Chong EA, Melenhorst JJ, Svoboda J, Nasta SD, Landsburg DJ, Mato AR, Tian L, Parakandi H, Lacey SF, June CH, Schuster SJ (2017) Phase I/II study of pembrolizumab for progressive diffuse large B cell lymphoma after anti-CD19 directed chimeric antigen receptor modified T cell therapy. Blood 130(Suppl 1):4121

    Google Scholar 

  • Davila ML, Riviere I, Wang X et al (2014) Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia. Sci Transl Med 6:224ra25

    Article  Google Scholar 

  • Di Stasi A, Tey SK, Dotti G et al (2011) Inducible apoptosis as a safety switch for adoptive cell therapy. N Engl J Med 365:1673–1683

    Article  Google Scholar 

  • Dudley ME, Yang JC, Sherry R et al (2008) Adoptive cell therapy for patients with metastatic melanoma: evaluation of intensive myeloablative chemoradiation preparative regimens. J Clin Oncol 26:5233–5239

    Article  CAS  Google Scholar 

  • Enblad GKH, Wikstrom K, Essand M, Savoldo B, Brenner MK, Dotti G, Hallbook H, Hoglund M, Hagberg H, Loskog A (2015) Third generation CD19-CAR T cells for relapsed and refractory lymphoma and leukemia report from the Swedish phase I/IIa trial. Blood 126:1534

    Google Scholar 

  • Eshhar Z, Waks T, Gross G et al (1993) Specific activation and targeting of cytotoxic lymphocytes through chimeric single chains consisting of antibody-binding domains and the gamma or zeta subunits of the immunoglobulin and T-cell receptors. Proc Natl Acad Sci U S A 90:720–724

    Article  CAS  Google Scholar 

  • Fraietta JA, Beckwith KA, Patel PR et al (2016) Ibrutinib enhances chimeric antigen receptor T-cell engraftment and efficacy in leukemia. Blood 127:1117–1127

    Article  CAS  Google Scholar 

  • Fraietta JA, Lacey SF, Orlando EJ et al (2018) Determinants of response and resistance to CD19 chimeric antigen receptor (CAR) T cell therapy of chronic lymphocytic leukemia. Nat Med 24:563–571

    Article  CAS  Google Scholar 

  • Fry TJ, Shah NN, Orentas RJ et al (2018) CD22-targeted CAR T cells induce remission in B-ALL that is naive or resistant to CD19-targeted CAR immunotherapy. Nat Med 24:20–28

    Article  CAS  Google Scholar 

  • Gardner R, Wu D, Cherian S et al (2016) Acquisition of a CD19-negative myeloid phenotype allows immune escape of MLL-rearranged B-ALL from CD19 CAR-T-cell therapy. Blood 127:2406–2410

    Article  CAS  Google Scholar 

  • Gisselbrecht C, Glass B, Mounier N et al (2010) Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J Clin Oncol 28:4184–4190

    Article  Google Scholar 

  • Hill JA, Li D, Hay KA et al (2018) Infectious complications of CD19-targeted chimeric antigen receptor-modified T-cell immunotherapy. Blood 131:121–130

    CAS  PubMed  Google Scholar 

  • Hombach A, Wieczarkowiecz A, Marquardt T et al (2001) Tumor-specific T cell activation by recombinant immunoreceptors: CD3 zeta signaling and CD28 costimulation are simultaneously required for efficient IL-2 secretion and can be integrated into one combined CD28/CD3 zeta signaling receptor molecule. J Immunol 167:6123–6131

    Article  CAS  Google Scholar 

  • Jackson HJ, Brentjens RJ (2015) Overcoming antigen escape with CAR T-cell therapy. Cancer Discov 5:1238–1240

    Article  CAS  Google Scholar 

  • Jensen MC, Popplewell L, Cooper LJ et al (2010) Antitransgene rejection responses contribute to attenuated persistence of adoptively transferred CD20/CD19-specific chimeric antigen receptor redirected T cells in humans. Biol Blood Marrow Transplant 16:1245–1256

    Article  CAS  Google Scholar 

  • Kebriaei P, Singh H, Huls MH et al (2016) Phase I trials using sleeping beauty to generate CD19-specific CAR T cells. J Clin Investig 126:3363–3376

    Article  Google Scholar 

  • Kloss CC, Condomines M, Cartellieri M et al (2013) Combinatorial antigen recognition with balanced signaling promotes selective tumor eradication by engineered T cells. Nat Biotechnol 31:71–75

    Article  CAS  Google Scholar 

  • Kochenderfer JN, Wilson WH, Janik JE et al (2010) Eradication of B-lineage cells and regression of lymphoma in a patient treated with autologous T cells genetically engineered to recognize CD19. Blood 116:4099–4102

    Article  CAS  Google Scholar 

  • Kochenderfer JN, Somerville R, Lu L et al (2014) Anti-CD19 CAR T cells administered after low-dose chemotherapy can induce remissions of chemotherapy-refractory diffuse large B-cell lymphoma. Blood 124:550

    Google Scholar 

  • Kochenderfer JN, Dudley ME, Kassim SH et al (2015) Chemotherapy-refractory diffuse large B-cell lymphoma and indolent B-cell malignancies can be effectively treated with autologous T cells expressing an anti-CD19 chimeric antigen receptor. J Clin Oncol 33:540–549

    Article  CAS  Google Scholar 

  • Kochenderfer JN, Somerville RPT, Lu T et al (2017a) Lymphoma remissions caused by anti-CD19 chimeric antigen receptor T cells are associated with high serum interleukin-15 levels. J Clin Oncol 35:1803–1813

    Article  CAS  Google Scholar 

  • Kochenderfer JN, Somerville RPT, Lu T et al (2017b) Long-duration complete remissions of diffuse large B cell lymphoma after anti-CD19 chimeric antigen receptor T cell therapy. Mol Ther 25:2245–2253

    Article  CAS  Google Scholar 

  • Lee DW, Gardner R, Porter DL et al (2014) Current concepts in the diagnosis and management of cytokine release syndrome. Blood 124:188–195

    Article  CAS  Google Scholar 

  • Locke FLNS, Bartlett NL, Siddiqi T, Chavez JC, Hosing CM, Ghobadi A, Budde LE, Navale L, Aycock JS, Wiezorek J, Go WY (2015) Phase 1 clinical results of the ZUMA-1 (KTE-C19-101) study: a phase 1-2 multi-center study evaluating the safety and efficacy of anti-CD19 CAR T cells (KTE-C19) in subjects with refractory aggressive non-Hodgkin lymphoma (NHL). Blood 126:3991

    Google Scholar 

  • Locke FL, Neelapu S, Bartlett NL, Lekakis LJ, Jacobson CA, Braunschweig I, Oluwole OO, Siddiqi T, Lin Y, Timmerman JM, Reagan PM, Bot A, Rossi JM, Sherman M, Navale L, Jiang Y, Aycock JS, Elias M, Wiezorek JS, Go WY, Miklos DB (2017) Preliminary results of prophylactic Tocilizumab after Axicabtagene ciloleucel (axi-cel; KTE-C19) treatment for patients with refractory, aggressive non-Hodgkin lymphoma (NHL). Blood 130(Suppl 1):1547

    Google Scholar 

  • Long M, Beckwith K, Do P et al (2017) Ibrutinib treatment improves T cell number and function in CLL patients. J Clin Investig 127:3052–3064

    Article  Google Scholar 

  • Matsuki E, Younes A (2016) Checkpoint inhibitors and other immune therapies for Hodgkin and non-Hodgkin lymphoma. Curr Treat Options Oncol 17:31

    Article  Google Scholar 

  • Maude SL, Frey N, Shaw PA et al (2014) Chimeric antigen receptor T cells for sustained remissions in leukemia. N Engl J Med 371:1507–1517

    Article  Google Scholar 

  • Neelapu SS, Locke FL, Bartlett NL et al (2017) Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. N Engl J Med 377:2531–2544

    Article  Google Scholar 

  • Otahal P, Prukova D, Kral V et al (2016) Lenalidomide enhances antitumor functions of chimeric antigen receptor modified T cells. Oncoimmunology 5:e1115940

    Article  Google Scholar 

  • Pegram HJ, Lee JC, Hayman EG et al (2012) Tumor-targeted T cells modified to secrete IL-12 eradicate systemic tumors without need for prior conditioning. Blood 119:4133–4141

    Article  CAS  Google Scholar 

  • Ramos CASB, Liu E, Gee AP, Mei Z, Grilley BJ, Rooney CM, Heslop HE, Brenner MK, Dotti G (2013) Clinical responses in patients infused with T lymphocytes redirected to target κ-light immunoglobulin chain. Blood 122:506

    Google Scholar 

  • Ramos CA, Ballarad B, Liu E, Dakhova O, Mei Z, Liu H, Grilley B, Rooney CM, Gee AP, Chang BH, Bollard CM, Brenner MK, Dotti G, Heslop HE, Savoldo B (2015) Chimeric T cells for therapy of CD30+ Hodgkin and non-Hodgkin lymphomas. Blood 126:185

    Article  Google Scholar 

  • Ramsay AG, Clear AJ, Fatah R et al (2012) Multiple inhibitory ligands induce impaired T-cell immunologic synapse function in chronic lymphocytic leukemia that can be blocked with lenalidomide: establishing a reversible immune evasion mechanism in human cancer. Blood 120:1412–1421

    Article  CAS  Google Scholar 

  • Riddell SR, Sommermeyer D, Berger C et al (2014) Adoptive therapy with chimeric antigen receptor-modified T cells of defined subset composition. Cancer J 20:141–144

    Article  CAS  Google Scholar 

  • Ruella M, Kenderian SS, Shestova O et al (2016) The addition of the BTK inhibitor Ibrutinib to anti-CD19 chimeric antigen receptor T cells (CART19) improves responses against mantle cell lymphoma. Clin Cancer Res 22(11):2684–2696

    Article  CAS  Google Scholar 

  • Santomasso BD, Park JH, Salloum D et al (2018) Clinical and biologic correlates of neurotoxicity associated with CAR T cell therapy in patients with B-cell acute lymphoblastic leukemia (B-ALL). Cancer Discov 8(8):958–971. https://doi.org/10.1158/2159-8290.CD-17-1319

    Article  CAS  PubMed  Google Scholar 

  • Sauter CS, Riviere I, Bernal Y et al (2015) Phase I trial of 19-28z chimeric antigen modified T cells (19-28z CAR-T) post-high dose therapy and autologous stem cell transplant (HDT-ASCT) for relapsed and refractory (rel/ref) aggressive B-cell non-Hodgkin lymphoma (B-NHL). J Clin Oncol 33:8515

    Google Scholar 

  • Schuster SJ, Svoboda J, Chong EA et al (2017a) Chimeric antigen receptor T cells in refractory B-cell lymphomas. N Engl J Med 377:2545–2554

    Article  Google Scholar 

  • Schuster SJ, Bishop MR, Tam CS, Waller EK, Borchmann P, McGuirk JP, Jaeger U, Jaglowski S, Andreadis C, Westin JR, Fleury I, Bachanova V, Ronan Foley S, Ho PJ, Mielke S, Magenau JM, Holte H, Van Besien K, Kersten MJ, Teshima T, Tobinai K, Corradini P, Anak O, Bubuteishvili Pacaud L, del Corral C, Awasthi R, Tai F, Salles G, Maziarz RT (2017b) Primary analysis of Juliet: a global, pivotal, phase 2 trial of CTL019 in adult patients with relapsed or refractory diffuse large B-cell lymphoma. Blood 130(Suppl 1):577

    Google Scholar 

  • Smith MR (2015) Ibrutinib in B lymphoid malignancies. Expert Opin Pharmacother 16:1879–1887

    Article  CAS  Google Scholar 

  • Till BG, Jensen MC, Wang J et al (2008) Adoptive immunotherapy for indolent non-Hodgkin lymphoma and mantle cell lymphoma using genetically modified autologous CD20-specific T cells. Blood 112:2261–2271

    Article  CAS  Google Scholar 

  • Turtle CJ, Hanafi LA, Berger C et al (2016) Immunotherapy of non-Hodgkin’s lymphoma with a defined ratio of CD8+ and CD4+ CD19-specific chimeric antigen receptor-modified T cells. Sci Transl Med 8:355ra116

    Article  Google Scholar 

  • Turtle CJ, Hay KA, Hanafi LA et al (2017) Durable molecular remissions in chronic lymphocytic leukemia treated with CD19-specific chimeric antigen receptor-modified T cells after failure of Ibrutinib. J Clin Oncol 35:3010–3020

    Article  CAS  Google Scholar 

  • Vose JM, Carter S, Burns LJ et al (2013) Phase III randomized study of rituximab/carmustine, etoposide, cytarabine, and melphalan (BEAM) compared with iodine-131 tositumomab/BEAM with autologous hematopoietic cell transplantation for relapsed diffuse large B-cell lymphoma: results from the BMT CTN 0401 trial. J Clin Oncol 31:1662–1668

    Article  CAS  Google Scholar 

  • Wang X, Popplewell LL, Wagner JR et al (2016) Phase I studies of central-memory-derived CD19 CAR T cell therapy following autologous HSCT in patients with B-cell NHL. Blood 127(24):2980–2990

    Article  CAS  Google Scholar 

  • Wrzesinski C, Paulos CM, Gattinoni L et al (2007) Hematopoietic stem cells promote the expansion and function of adoptively transferred antitumor CD8 T cells. J Clin Investig 117:492–501

    Article  CAS  Google Scholar 

  • Younes A, Bartlett NL, Leonard JP et al (2010) Brentuximab vedotin (SGN-35) for relapsed CD30-positive lymphomas. N Engl J Med 363:1812–1821

    Article  CAS  Google Scholar 

  • Zah E, Lin MY, Silva-Benedict A et al (2016) T cells expressing CD19/CD20 Bispecific chimeric antigen receptors prevent antigen escape by malignant B cells. Cancer Immunol Res 4(6):498–508

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Craig S. Sauter .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Batlevi, Y., Sauter, C.S. (2019). Chimeric Antigen Receptor T Cells for Lymphomas: Methods, Data, and Challenges. In: Perales, MA., Abutalib, S., Bollard, C. (eds) Cell and Gene Therapies. Advances and Controversies in Hematopoietic Transplantation and Cell Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-54368-0_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54368-0_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54367-3

  • Online ISBN: 978-3-319-54368-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics