Treatment Outcomes for Patients with Mantle Cell Lymphoma Following CD19-Directed CAR-T Therapy

Strategic Insights -

A study published in Blood Advances has investigated the treatment patterns and clinical outcomes for patients with mantle cell lymphoma who experienced progression-of-disease (POD) following CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy. The research identified 135 patients (35% of 384 total patients) who experienced POD, with most patients (64%) having complete response as best response to CAR-T therapy. The study highlighted the challenging prognosis for patients experiencing POD and established a benchmark for future investigations in this patient population.

Key Takeaways:

  • The study identified 135 patients (35% of 384 total patients) who experienced POD following CD19-directed CAR-T therapy, with a median time to POD of 6 months.
  • Most patients (64%) with POD had complete response as best response to CAR-T therapy.
  • Tumor features at POD included blastoid/pleomorphic morphology in 29/78 (37%) patients and TP53 mutation in 21/41 (51%) patients.
  • Following POD, 17 patients received no further therapy, 13 underwent local therapy, and 105 received systemic therapy.
  • The most common first-line systemic therapies were chemo(immuno)therapy (22 patients, overall response rate (ORR) 40%), pirtobrutinib (17 patients, ORR 36%), and bi-specific antibodies (BsAb), received by 13 patients, ORR 67%.
  • Among patients experiencing POD, the median progression-free and overall survival was 2.5 months and 5.4 months, respectively, from POD.
  • Lack of response to CAR-T and short time from CAR-T infusion to POD (6 months) were associated with inferior overall survival post-POD.
  • The study confirmed the challenging prognosis for patients experiencing POD following CD19 CAR-T for relapsed or refractory (R/R) MCL and established a benchmark for future investigations in this patient population.

Statistics:

  • 384 total patients received CAR-T therapy.
  • 135 patients (35%) experienced POD following CAR-T therapy.
  • 64% of patients with POD had complete response as best response to CAR-T therapy.
  • Median time to POD was 6 months.
  • Median progression-free survival was 2.5 months from POD.
  • Median overall survival was 5.4 months from POD.
  • 37% of patients with POD had blastoid/pleomorphic morphology.
  • 51% of patients with POD had TP53 mutation.

Sources:

  • "Treatment and outcomes of progression of disease post-CAR T-cell therapy in mantle cell lymphoma: a multicenter analysis" (Blood Advances, 2025)
  • University of Texas MD Anderson Cancer Center
  • Anath Christopher Lionel, University of Texas MD Anderson Cancer Center, Houston, Texas, United States
  • Zachary D. Epstein-Peterson, Ashlee Joseph, Esther Drill, Suheil Albert Atallah-Yunes, Taylor R. Brooks, Elise A. Chong, Emeline R. Chong, Jamie Dela Cruz, Matthew J. Frank, Andrew Ip, Madiha Iqbal, Caron A. Jacobson, and Manali Kam
  • Blood Advances (Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands)