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Medientyp:
E-Artikel
Titel:
Brexucabtagene Autoleucel: A Novel Chimeric Antigen Receptor T-cell Therapy for the Treatment of Mantle Cell Lymphoma
Beteiligte:
Anderson, Mary Kate;
Torosyan, Annie;
Halford, Zachery
Erschienen:
SAGE Publications, 2022
Erschienen in:
Annals of Pharmacotherapy, 56 (2022) 5, Seite 609-619
Sprache:
Englisch
DOI:
10.1177/10600280211026338
ISSN:
1060-0280;
1542-6270
Entstehung:
Anmerkungen:
Beschreibung:
Objective: To identify and assess the current literature surrounding the safety, efficacy, and practical considerations of brexucabtagene autoleucel (brexu-cel) for the treatment of relapsed or refractory (r/r) mantle cell lymphoma (MCL). Data Sources: An English-based literature search was conducted using the terms “ brexucabtagene autoleucel” AND “ mantle cell lymphoma” OR “ KTE-X19”in PubMed (inception through May 1, 2021), EMBASE (inception through May 1, 2021), and ClinicalTrials.gov. Study Selection and Data Extraction: All studies evaluating the use of brexu-cel in MCL were considered for inclusion. Data Synthesis: In the pivotal ZUMA-2 trial, brexu-cel demonstrated objective response and complete response rates of 85% and 59%, respectively. These results were consistent among high-risk subgroups. Noteworthy treatment-related adverse effects included grade ≥3 cytopenias (94%), immune effector cell–associated neurotoxicity syndrome (31%), and cytokine release syndrome (15%). Brexu-cel elicited a toxicity profile similar to that of other novel chimeric antigen receptor (CAR) T-cell products, with no new safety signals. Relevance to Patient Care and Clinical Practice: There are currently no head-to-head clinical trials evaluating brexu-cel against other approved subsequent-line options in r/r MCL. In a relatively small phase II trial, brexu-cel demonstrated impressive response rates in heavily pretreated patients, with few viable alternatives. Long-term safety and efficacy outcomes with brexu-cel are unknown. The prevention, identification, and management of unique CAR T-cell toxicities requires expert care from a well-trained interdisciplinary team. Conclusion: Brexu-cel has emerged as a viable treatment option in MCL. Additional studies are required to determine the optimal sequencing and place in therapy for brexu-cel in this highly heterogeneous, pathobiologically distinct, and incurable malignancy.