This trial is evaluating whether CAR T Cells will improve 1 primary outcome and 3 secondary outcomes in patients with Lymphoma. Measurement will happen over the course of 6 weeks.
This trial requires 66 total participants across 2 different treatment groups
This trial involves 2 different treatments. CAR T Cells is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase 1 and are in the first stage of evaluation with people.
Immune system issues and lifestyle factors have been linked to non-Hodgkin's lymphoma. More work is needed to evaluate the relationship between lifestyle factors and B-cell lymphoma.
Recent findings indicate that Car T cell-based immunotherapies as a first-line treatment may be the most important achievement obtained in the field of T cell treatments.
Common chemotherapeutic agents found to be effective included Cyclophosphamide, CHOP, VB and AC, the latter two by far the most common. The most commonly reported combinations included Cyclophosphamide and VB, Cyclophosphamide with VB, VBT and VB plus AC, VBT+CHOP+VAC, VBT plus CHOP, CHP with VB and the less common combinations of CHOP+VAC, CHOP+ABC, VB, CHOP+AB and VBT.
Lymphoma is one of the fastest growing cancers in the UK and one of the top five cancer killers. Lymphoma has 3 distinct categories, Hodgkin's Lymphoma, non-Hodgkin's Lymphoma and [mantle cell lymphoma](https://www.withpower.com/clinical-trials/mantle-cell-lymphoma). The most common sites of lymphoma are the lymph nodes (15%), blood and gastrointestinal tissues (8%), bone/muscle (8%) and mucosal tissues (5%).\n
A significant majority of patients have an indicator of lymphoma. The most common symptom is persistent weight loss, but any gastrointestinal or weight change should be evaluated. Imaging often reveals a wide systemic dissemination, including the lungs and bone marrow. Testicular enlargement raises suspicion of non-Hodgkin's lymphoma.
One in 200 men will develop non-Hodgkin's Lymphoma. The relative risk of developing non-Hodgkin's Lymphoma increases as men age; men who develop non-Hodgkin's Lymphoma are almost three and a half times more likely than men who never develop lymphoma to have an exposed male first degree relative with lymphoma. Risk factors for non-Hodgkin's lymphoma are more broadly defined than risk factors for Hodgkin's lymphoma.
Since the 1990s, there has been a dramatic decrease in long- term survival of patients with non-Hodgkin's lymphoma, and recent research has yielded significant advances in understanding the mechanisms of this disease and developing new techniques for treating non-Hodgkin's lymphoma, particularly in the areas of immune function, oncogene therapies, and cellular immunity. Patients with non-Hodgkin's lymphoma have demonstrated excellent responses to chemotherapy. However, there is still a need for effective treatments for other B-cell lymphomas. Further clinical research remains required for the identification of effective treatments for patients with multiple disparate types of lymphoma and the development of novel agents or chemotherapy regimens for improving OS.
We found that CAR-T and CAR-T + cyclophosphamide are not promising candidates for clinical investigation, and the role of CAR-T in treatment of aggressive lymphomas remains unfound. However, we believe that these results and the literature herein will be helpful when looking at the potential clinical benefit of CAR-T in other lymphoma subtypes in the near future.
Patients with low-intermediate-grade (I-I) NHL have a shorter remission time, a higher relapse risk and a lower survival time than patients with high-grade (H) NHL, particularly if they're of B cell origin; therefore high-grade B cell lymphomas should be addressed as the most harmful. Nevertheless, the treatment with standard chemotherapy (CTX) alone or with combined therapy (RTX) has proven to be efficacious in several types of NHL, particularly in patients with low-intermediate-grade (I-I) NHL and in those in partial remissions after chemotherapy.
A variety of common and common uncommon side effects have been described. Common side effects were fatigue, nausea, diarrhea, pain in extremities that often subsided in less than a day, headache and insomnia in 2 or 3% of the patients. Pain in the extremities was the most common very uncommon side effect. It is most frequently present in women, starts in the upper extremities and fades after 24 hours. While we rarely saw itchiness nor pain in the nose or throat when using the car t cell infusion our patients have been mostly female with breast cancer. This pain is probably due to high concentrations of MDA2.
This novel approach of car and cT cells from CAR adoptive cell transfer has promising therapeutic implications for the treatment of hematological malignancies or tumors that are non-responsive to therapy, particularly relapsed disease.