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Tisagenlecleucel CAR-T Cell Therapy in Secondary CNS Lymphoma

Matthew J. Frigault, Jorg Dietrich, Maria Martinez-Lage, Mark Leick, Bryan D. Choi, Zachariah DeFilipp, Yi-Bin Chen, Jeremy Abramson, Jennifer Crombie, Philippe Armand, Lakshmi Nayak, Christopher Panzini, Lauren S. Riley, Kathleen Gallagher and Marcela Maus

Key Points

  • Tisagenlecleucel for secondary CNS lymphoma has an acceptable safety profile.

  • Preliminary results using tisagenlecleucel demonstrate activity in a heavily pretreated population.

Abstract

Chimeric antigen receptor (CAR) T-cells targeting CD19 have emerged as a leading engineered T-cell therapy for relapsed/refractory B-cell non-Hodgkins lymphoma (B-NHL). The phase I/II clinical trials that led to FDA approval excluded patients with central nervous system (CNS) involvement, due to strict eligibility criteria. Here we report on our institutional experience with 8 secondary CNS lymphoma patients treated with commercial tisagenlecleucel. No patient experienced >grade 1 neurotoxicity and no patient required tocilizumab or steroids for CAR-T mediated toxicities. Biomarker analysis suggested CAR-T cell expansion despite the absence of systemic disease and early response assessments demonstrated activity of intravenously infused CAR-T cells within the CNS space.

  • Submitted May 21, 2019.
  • Revision received July 18, 2019.
  • Accepted July 10, 2019.