CAR T-Cell Therapy for Large B-Cell Lymphoma — Who, When, and How?

Large B-cell lymphoma is a spectrum of aggressive B-cell cancers with broad genetic and clinical heterogeneity. 1 First-line chemotherapy cures most patients, but those with relapsed or refractory disease usually die of lymphoma. Salvage chemotherapy followed by autologous stem-cell transplantation (ASCT) is the standard second-line approach to large B-cell lymphoma and cures up to 30 to 40% of eligible patients, but it is restricted to younger, fit patients and is relatively ineffective in chemotherapy-refractory disease. 2 Chimeric antigen receptor (CAR) T-cell therapies that target CD19 have advanced the treatment of multiply relapsed large B-cell lymphoma and showed promising rates of durable remission . . .