Chimeric Antigen Receptor (CAR) T-cell Therapy in the Treatment of Diffuse Large B-cell Lymphoma (DLBCL): A Systematic Review.

Chimeric antigen receptor (CAR) T-cell therapy has shown very promising results in the treatment of refractory or relapsed diffuse large B-cell lymphoma (DLBCL). This systematic review evaluates the effectiveness and side effects of CAR T-cell therapies, focusing on factors affecting both clinical outcomes and adverse effects. This review included data from 14 studies involving 1392 patients with DLBCL who underwent CAR T-cell therapy. These studies include both randomized clinical trials and observational studies, which would help to analyze the effectiveness and safety profiles. The review highlights that CAR T-cell therapies, mainly tisagenlecleucel (Tisa-cel) and axicabtagene ciloleucel (Axi-cel), have shown superior effectiveness in comparison to standard chemotherapy in patients with relapsed or refractory DLBCL. Lisocabtagene maraleucel (Liso-cel) showed significant improvement outcomes in event-free and progression-free survival. However, CAR T-cell therapies are associated with many side effects. The most common side effects include hematologic toxicity, prolonged neutropenia, and infections, while clinical outcomes are highly impacted by many factors, which include a pro-inflammatory state, PPM1D gene mutation, infusion timing, and circulating monocytes.