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CAR T-Cell Therapy for Relapsed and Refractory Mantle Cell Lymphoma
Patients with mantle cell lymphoma treated at Fox Chase Cancer Center will now have access to treatment with brexucabtagene autoleucel (also known as TecartusTM), the first cell-based gene therapy approved by the Food and Drug Administration (FDA).
Tecartus, a chimeric antigen receptor (CAR) T-cell therapy, was recently approved for adults with mantle cell lymphoma who have not responded to or who have relapsed following other kinds of treatment, and Fox Chase is a certified treatment center for the therapy.
With CAR T-cell therapy, patients’ T cells are collected and genetically modified to include a new gene that helps target and kill lymphoma cells. These modified T cells are then infused back into the patient.
“This is one of the most promising therapies for patients with mantle cell lymphoma, including those with a type of disease called P53-mutated mantle cell lymphoma,” said Henry Chi Hang Fung, MD, FACP, FRCPE, Chair of the Department of Bone Marrow Transplant and Cellular Therapies at Fox Chase.
Fung was an investigator on the clinical trial that led to the FDA’s approval of Tecartus, which looked at the safety and efficacy of the therapy in patients with relapsed or refractory mantle cell lymphoma. In the trial, 87% of participants responded to a single infusion of the therapy, and all signs of cancer disappeared—a complete response—in 62% of patients.
“A complete response rate of greater than 60% with Tecartus is even better than responses seen with first-line treatment after the initial diagnosis,” Fung said. “It is a very effective treatment.”
Mantle cell lymphoma is an uncommon subtype of non-Hodgkin lymphoma that occurs in cells originating in the mantle zone of the lymph node.
Patients diagnosed with the disease will typically undergo initial treatment with chemotherapy or a stem cell transplant. However, even with transplant, the disease often recurs.
In recent years, several other treatments known as Bruton’s tyrosine kinase (BTK) inhibitors have been approved for patients with mantle cell lymphoma who have received at least one prior type of therapy; however, these medications aren’t always enough.
“When patients failed these treatments in the past, even after having durable responses, we had nothing to offer them,” Fung said. “The responses we are seeing with Tecartus are like nothing we have seen in the history of mantle cell lymphoma.”
Fox Chase also provides FDA-approved CAR T-cell therapy for relapsed or refractory large B-cell lymphoma in adults and refractory B-cell precursor acute lymphoblastic leukemia in young adults up to 25 years old.
The effectiveness of cellular immunotherapy against other blood cancers is also being explored and, specifically at Fox Chase, a variety of clinical trials are being conducted on this treatment for multiple myeloma, follicular lymphoma, and chronic lymphocytic leukemia.