Harnessing CAR T-cell therapy: A new study for indolent B-cell non-Hodgkin lymphoma
Indolent B-cell non-Hodgkin lymphoma (NHL) is a type of cancer that affects B cells, which are responsible for producing antibodies to fight infections. Unlike other aggressive forms of NHL, indolent B-cell lymphomas progress more slowly and may not cause symptoms for years. For this reason, these types of lymphomas are sometimes referred to as "low-grade" lymphomas.
The most common types of indolent B-cell NHL are follicular lymphoma (FL), marginal zone lymphoma (MZL) and small lymphocytic lymphoma (SLL), which is closely related to chronic lymphocytic leukemia (CLL).
A global, phase II clinical trial currently enrolling patients at Providence Cancer Institute of Oregon is seeking a new treatment option for adult patients with indolent B-cell NHL (follicular lymphoma or marginal zone lymphoma) that has relapsed or no longer responds to therapy.
The study, known as TRANSCEND FL, is evaluating the effectiveness and safety of lisocabtagene maraleucel (liso-cel) or JCAR-017, a type of CAR T-cell therapy. TRANSCEND FL recently opened a new extension cohort for patients with relapsed or refractory follicular lymphoma who have received only one prior line of combination systemic therapy.
Three phase study by design
TRANSCEND FL is open-label and multicohort, meaning all participants will receive liso-cel and data will be collected from multiple groups of patients. There are three phases of the study:
- Pretreatment (screening assessments, leukapheresis and the pretreatment evaluation)
- Treatment (starts at administration of lymphodepleting chemotherapy and continues through liso-cel administration at Day 1 with follow-up through Day 29)
- Post-treatment (follow-up assessments for disease status and safety for five years)
The objectives of TRANSCEND FL are to evaluate safety and efficacy of liso-cel, as well as how patients react to the therapy (pharmacokinetics) and their quality of life during and after treatment.
What is liso-cel and how does it work?
Liso-cel is a type of CAR T-cell therapy, a form of immunotherapy that modifies a patient’s own immune cells to fight cancer. Here’s how it works:
- T cells, a type of white blood cell, are collected from the patient’s blood through a process called leukapheresis.
- The T cells are then genetically engineered in a laboratory to produce a special receptor called a chimeric antigen receptor (CAR). In the case of liso-cel, the CAR is designed to target the CD19 protein, which is found on the surface of certain cancerous B cells, such as those involved in lymphomas and leukemias.
- After modification, the newly engineered CAR T cells are multiplied in the lab to create millions of these cancer-fighting cells.
- CAR T cells are infused back into the patient. Before the infusion, the patient typically undergoes lymphodepleting chemotherapy to reduce the number of immune cells, which helps the CAR T cells expand and work more effectively.
- Once inside the body, the CAR T cells can recognize and bind to the CD19 protein on the surface of the cancerous B cells. This binding activates the CAR T cells, prompting them to attack and kill the cancer cells.
The overall response rate of this study is defined as the percentage of patients participating in the trial who achieve either a partial response or complete response at any time up to 60 months (five years). Treatment will be assessed by PET-CT and/or CT using Lugano classification, a system for defining stages of Hodgkin lymphoma and NHL.
Learn more or refer a patient
TRANSCEND FL is conducted in compliance with the International Council on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use/Good Clinical Practice and applicable regulatory requirements.
Providence Portland Medical Center is the only Providence Cancer Institute site currently enrolling patients in TRANSCEND FL. The principal investigator is Stacy K. Lewis, M.D., medical oncologist, Providence Cancer Center Oncology and Hematology Care Clinic, Westside Portland.
Contact our clinical research office with questions:
- Call 503-215-1979
- Submit a referral form
- Send an email
New research studies are added frequently. To see more clinical studies, visit:
- Studies for blood cancers.
- All cancer studies at Providence Cancer Institute
Providence Blood Cancers and Blood Disorders Program
Find out more about our blood disorder and blood cancer program. As one of the few highly specialized blood cancer treatment centers in the region, we provide world-class care and promising new therapies. In addition to receiving a high level of care and support, patients with blood disorders have the opportunity to participate in innovative clinical trials to treat leukemia, lymphoma, myelodysplastic syndromes and myeloma.
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