Factors associated with long-term outcomes of CD19 CAR T-cell therapy for relapsed/refractory CLL

Researchers of a phase I/II trial of CD19-directed CAR T-cell therapy analyzed 47 patients with relapsed/refractory CLL and/or Richter transformation. Although there is ongoing room for improvement for CAR T-cell therapy in CLL and Richter's Transformation as a whole (at a median follow-up of 79.6 months, median progression-free survival (PFS) was 8.9 months and the 6-year PFS was 17.8%), certain patients do experience durable responses with the potential that CAR T-cell therapy may be curative in a subset of patients. Bulky lymph nodes prior to CAR T-cell therapy were associated with decreased response to CAR T-cell therapy. However, notably, median duration of response in patients who exhibited measurable residual disease (MRD) negativity by next-generation sequencing was 53.4 months—an impressive time frame in light of this heavily refractory patient population. Ongoing efforts are needed to improve on CAR T-cell therapy for this patient population.