Chimeric Antigen Receptor T-Cell Therapy for Hematologic Malignancies: A Practical Review

JCO Oncol Pract. 2023 Sep;19(9):706-713. doi: 10.1200/OP.22.00819. Epub 2023 Jul 5.

Abstract

Chimeric antigen receptor T-cell (CAR-T) therapy has become an established therapeutic approach for the treatment of hematologic malignancies. The field continues to evolve rapidly and newer-generation constructs are being designed to enhance proliferative capacity, and achieve long-term persistence and greater efficacy with an overall lower incidence of toxicity. Initial clinical application of CAR-T therapies has focused on relapsed and/or refractory hematologic malignancies, and Food and Drug Administration-approved CAR-T products targeting CD19 are available for B-cell acute lymphoblastic leukemia and low- and high-grade B-cell non-Hodgkin lymphoma, and targeting B-cell maturation antigen are available for multiple myeloma. Cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome have been recognized as class specific toxicities associated with these novel therapies. In this review, we focus on the clinical application of CAR-T therapies in adult patients with hematologic malignancies, including access issues, outpatient administration, and appropriate timing for referring a patient to a CAR-T treatment center.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cell- and Tissue-Based Therapy
  • Hematologic Neoplasms* / drug therapy
  • Humans
  • Receptors, Antigen, T-Cell / therapeutic use
  • Receptors, Chimeric Antigen* / therapeutic use
  • United States

Substances

  • Receptors, Chimeric Antigen
  • cell-associated neurotoxicity
  • Receptors, Antigen, T-Cell