CAR T Cell Therapy in Treating Blood Cancers

Arianna Boja

March 14, 2022

Intern/Mentor 2021-2022

Dr. Melissa Kiehl

Abstract

Immunotherapy is a broad category of cancer treatment involving using a patient’s

immune system to eliminate cancerous cells; immunotherapy encompasses several different

treatments, including CAR T cell therapy, a type of adoptive T-cell immunotherapy that can be

used to treat cancers. T cells are an important component of our immune system and assist in

targeting and eliminating foreign substances in our bodies, and are used in CAR T cell therapy to

target cancerous cells. Patient’s cells are collected and transformed by introducing a chimeric

antigen receptor (CAR), where the T-cells are reintroduced into the patient’s bloodstream. This

antigen receptor can identify and target a specific structure in the patient’s cells, and then

multiply and attack these cells containing the specific target structure (Mäkelä, 2021).

Conducting further research on CAR T cell therapy and continuing to demonstrate its useful

applications can help significantly advance cancer treatment and how we conduct future

research. Additionally, having scientists and researchers understand the side effects caused by

CAR T cell therapy and modifying the treatment can help increase survival in patients with

blood cancer.

From an analysis of CAR T cell therapy clinical trials, CAR T demonstrates its efficacy

in treating patients with blood cancer in comparison to other methods of traditional cancer

treatments. In analyzing response rates and median overall survival, patients in the CAR T cell

group had overall higher rates compared to patients in the standard of care group. Demonstrating

CAR T cell therapy’s success can help boost its applications in blood cancer treatment as well as

allow for further developments and research to advance CAR T and cancer treatment as a whole.

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Introduction

With advancements in the science and medical field being made and pushing the

boundaries of how we diagnose and treat diseases, new and innovative methods of treatment are

constantly being explored. Cancer is a complex disease, which can stem from a multitude of

issues such as environmental factors or family history. One relatively new development in the

cancer treatment field focuses on utilizing a patient’s natural immune defenses to fight cancer,

and shifts away from using traditional therapies including chemotherapy and radiation therapy.

Scientists can reengineer a patient’s immune system, and aid them to fight and eliminate cancer.

Immunotherapy is a broad term to describe a method of cancer treatment, involving the use and

boosting of a patient’s own immune system to fight and target cancerous cells. CAR T cell

therapy is a specific subset of immunotherapy involving the extraction of T-cells from a patient’s

bloodstream, where scientists then transform the patient’s T-cells by attaching a synthetic

receptor. This synthetic receptor recognizes and binds to a target antigen on the cancerous cells,

eliminating it. Because of CAR T cell therapy’s promising clinical trial results and its ability to

effectively target cancerous cells, CAR T cell therapy is the most effective prospective method of

treating blood cancers. This paper will examine the mechanisms of CAR T cell therapy, the

effectiveness of CAR T, and why CAR T cell therapy will become the most effective cancer

treatment method for patients with blood cancer.

Cancer is a complex disease; understanding and recognizing cancers, the causes of

cancer, how to treat cancer, and how cancer spreads involve many factors which need to be taken

into consideration. Cancer is a general term to describe a condition in which the body’s cells

divide rapidly and grow out of control. Normal cells only grow under certain conditions, and

follow the general cell cycle, involving stages of growth and replication. However, cancerous

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cells are able to grow and divide rapidly, advancing through the stages of the cell cycle at an

uncontrolled rate (“What is cancer?,” n.d.). These cancerous cells are also able to effectively

“trick” the immune system; where the immune system normally is able to recognize and attack

damaged cells and foreign objects, the cancerous cells are able to evade the immune system’s

natural defenses. To provide a source for oxygen and nutrients for their rapid divisions,

cancerous cells are able to route blood vessels to grow towards the tumor, also allowing for the

removal of waste material (“What is cancer?,” n.d.). Blood cancer is one specific type of cancer,

involving the rapid and uncontrolled growth of blood cells. Blood cells are produced in the bone

marrow, where most blood cancers originate. Fighting off foreign particles and infections is one

of the functions of blood cells which is inhibited by the abnormal growth of cancerous blood

cells. Blood cancers can be divided into three main subgroups: leukemia, lymphoma, and

myeloma. Leukemia originates from the blood and bone marrow and involves the rapid,

abnormal growth of white blood cells, resulting in the interference with the bone marrow’s

ability to create red blood cells and platelets. Lymphoma can then be divided into two categories,

Non-Hodgkin lymphoma, and Hodgkin lymphoma. Non-Hodgkin lymphoma develops from

lymphocytes, a type of white blood cell that fights infections (“Blood cancers,” n.d.). Hodgkin

lymphoma also develops from lymphocytes; however, it is different in the sense that the

Reed-Sternberg cell, a type of abnormal lymphocyte, is present in this form of lymphoma and not

in Non-Hodgkin lymphoma. Multiple myeloma involves cancer growth originating in the blood’s

plasma cells, which are a type of white blood cell (“Blood cancers,” n.d.).

In order to fight and treat cancer, the cancer treatment method must effectively target and

eliminate ideally all of the cancerous cells. If one cancerous cell is left behind, the cycle may

repeat itself. Some cancer treatment methods include surgery, radiation, chemotherapy, and

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immunotherapy; based on certain factors such as the type of cancer a patient has or how far the

cancer has progressed in the patient, a doctor may make different recommendations for a

treatment plan, which can involve the use of several different treatment methods.

Review of Literature

Examining the biological mechanisms behind CAR T cell therapy and immunotherapy as

a whole provides insight into why it is the most effective cancer treatment method.

Immunotherapy involves reengineering the patient's immune system to eliminate cancerous cells,

and enables it to recognize and eliminate foreign objects, and/such as damaged or abnormal cells

(“What is cancer?,” n.d.). However, since cancerous cells are able to evade the immune system’s

natural defenses and essentially “hide,” scientists are able to administer various treatments to

boost or reengineer the immune system to effectively fight and eliminate target cancerous

tumors. Based on the type of cancer a patient has, different immunotherapies may be more or

less effective in targeting the cancer cells. For instance, CAR T cell therapy is most effective in

areas with high perfusion and generally is administered to blood cancer patients. CAR (chimeric

antigen receptor) T cell therapy is a type of immunotherapy utilizing the patient’s T cells to

attack cancerous cells. T cells are a type of white blood cell that assists in fighting foreign

particles in the body and are activated once they find their specific antigen and bind to the target

antigen (Ryding, 2021). “T cells express a receptor with the potential to recognize diverse

antigens from pathogens, tumors, and the environment, and also maintain immunological

memory and self-tolerance” (Kumar et al., 2018). T cells are the key component in CAR T cell

therapy, involving several steps, the first of which is T cell collection. T cells are first collected

from a patient through an IV (Barrel, 2021), where white blood cells are removed, and the rest of

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the blood is returned to the patient (“CAR T-cell therapy and its side effects,” n.d.). T cells are

then transformed by introducing a CAR to the T cell via retroviral or lentiviral vectors (Fesnak &

O'Doherty, 2017). CARs are synthetic receptors attached to the T cells that assist and redirect

lymphocytes, usually T cells, to recognize and eliminate cells that contain the specific target

antigen. CAR structure consists of four general components, “(1) an extracellular target

antigen-binding domain, (2) a hinge region, (3) a transmembrane domain, and (4) one or more

intracellular signaling domains” (Sterner & Sterner, 2021). The antigen binding domain allows

for the CAR to target specific antigens, crucial to recognizing and eliminating cancerous cells,

minimizing the damage done to normal and healthy cells. Affinity is an important aspect of the

antigen domain, as it determines the function of the CAR; a CAR has to be able to recognize

antigens on tumor cells, induce CAR signaling, and activate T cells. Because of this, the binding

affinity has to be high, but not too high. The hinge region is a region of the CAR that allows

flexibility and allows the antigen binding domain to target the target antigens. The

transmembrane domain anchors the CAR to the membrane of the T cell, however, research may

indicate that this region can also assist in the function of the CAR T cell (Sterner & Sterner,

2021). After the CAR is attached to the T cell, the cells are allowed to multiply until the desired

concentration is reached, and they are then reintroduced into the patient’s bloodstream. This

antigen receptor can identify and target a specific structure in the patient’s cells, and attack these

cells containing the specific target structure (Mäkelä, 2021). The mechanisms behind CAR T cell

therapy suggest why CAR T therapy is effective in theory, and real-world data can further

support its efficacy.

As a whole, immunotherapy is revolutionizing the way cancer is treated. Immunotherapy

is a relatively new method of treatment in the clinical treatment field, however, shows great

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promise with further clinical trials. Examining the processes and procedures behind CAR-T's

success provides insight into the effectiveness CAR T cell therapy demonstrates. From Michael

Bishop of the University of Chicago School of Medicine “The CAR T-cell therapy success rate is

about 30% to 40% for lasting remission, with no additional treatment…” (Bartosch, 2019). Using

methods of immunotherapy such as CAR T cell therapy effectively boosts the immune system

while providing targeted treatment of cancer. During the CAR T cell manufacturing process, a

CAR is added to T cells, allowing for a targeted attack on cancer cells containing the specific

target antigen. T cells contain receptors for foreign substances that “match” with a specific

antigen on the foreign cell’s surface, and these fit together in a “lock and key” manner, however,

if T cells do not contain the receptor expressed on the cancer cells’ surface, T cells will not

recognize and eliminate the tumor. Adding a synthetic receptor to match and target antigens

expressed on the cancer cells allows for a more accurate and targeted approach to eliminating

tumors. For instance, in certain leukemias and lymphomas, the cancer cells express an antigen

called CD19. T cells with a receptor to target CD19 will be able to bind to cells expressing this

antigen; however, these T cells would remain ineffective in eliminating cancer cells without the

CD19 antigen (“CAR T-cell therapy and its side effects,” n.d.). This approach to targeting cells

expressing a certain antigen decreases the overall side effects seen in patients in comparison to

other traditional cancer treatment methods such as radiation or chemotherapy. Radiation to treat

cancer can be effective, but may prove difficult in treating cancer if the cancer has metastasized.

Radiation can be given in three ways, external radiation, internal radiation, and systemic

radiation, but generally works to treat cancer by damaging the DNA inside cells which causes

cell deaths and prevents them from growing and potentially spreading (“How radiation therapy is

used to treat cancer,” n.d.). Chemotherapy is another method of treating cancer, but has harmful

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side effects. Cancer cells grow and divide rapidly and out of control, and chemotherapy drugs

work by attacking any fast-growing cells. However, chemotherapy presents issues since our

bodies naturally contain healthy cells that divide fast, including cells in our heart, kidneys, and

intestine. Attacking and killing these healthy cells can result in side effects such as fatigue, hair

loss, nausea, and infection. Healthy cells that are most likely to be damaged by chemotherapy

include blood-forming cells in the bone marrow, hair follicles, and cells in the mouth and

digestive system (“Chemotherapy side effects,” n.d.). By administering CAR T cell therapy,

these harsh side effects are able to be avoided and can effectively target cancer cells that may

have spread through the bloodstream.

Administering CAR T cell therapy over other traditional methods of treatment renders

successful results while also mitigating some of the harmful side effects from other traditional

treatments described earlier. CAR T cell infusions are administered through an IV and travel

directly into the bloodstream, where blood cancers would already be present. The CAR T cells

are injected directly to where the site of the tumors would be, allowing for the T cells to quickly

recognize and attack target cancer cells. Since CAR T is most effective in places with high

perfusion, it remains efficacious in the treatment of blood cancers.

Currently, no cancer treatment boasts a 100% success rate with no side effects, however,

with more research and clinical trials underway, scientists can hope to improve the success rates

of various immunotherapies, specifically CAR T cell therapy in patients with blood cancer, and

mitigate the side effects of CAR T. The biological mechanisms behind CAR T provide insight

into its efficacy, with a targeted attacking approach to eliminate cancerous cells containing a

specific target antigen. The effectiveness of CAR T in blood cancers can also be attributed to

CAR-T's success in high perfusion areas, and its proximity to the site of cancerous cells.

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Comparing CAR T cell therapy to other traditional methods of treatment, therapies such as

radiation and chemotherapy come with severe drawbacks and harmful side effects. With new

research, CAR T cell therapy will become the most effective prospective method of treating

blood cancers.

In cancer treatment, having a method of treatment that not only is effective in targeting

and eliminating cancer but also with minimal side effects is crucial, and CAR T cell therapy can

provide both. Based on the methodology and mechanisms behind CAR T cell therapy, it becomes

evident why it is effective in treating blood cancer; by being able to effectively target and

eliminate cancerous cells with fewer side effects than traditional therapies, CAR T proves its use

in blood cancer treatment.

Methods and Data Collection

For this research, meta-analysis was used to answer the research question, will CAR T

cell therapy become the most effective method of treating blood cancers? After completing

background research, data collection, and data analysis, the concluded hypothesis is CAR T cell

therapy is more effective than standard of care treatments in treating blood cancers and through

overcoming associated limitations, will become the most effective method of treating blood

cancers. To test this hypothesis, evaluation research was used. Evaluation research was the best

design model for this research because the end goal is to evaluate and demonstrate how CAR T

cell therapy is not only useful for cancer treatment, but the most effective method of treating

blood cancers. This type of research is a mixed-method research, as it can include qualitative and

quantitative data. In this research study, the independent variable evaluates patients treated with

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CAR T vs. other methods of treatment, and the dependent variable is the outcome with each

method of treatment.

For this meta-analysis, three documents were annotated and analyzed to compile a chart

(Appendix A) of sources and relevant pieces of information to assist in supporting the

hypothesis. Data were collected by analyzing and researching various journals and locating key

details. These pieces of information were then added to a table under their respective row,

depending on how each piece is relevant to CAR T cell therapy, and how it supports the

hypothesis that CAR T cell therapy is more effective than standard of care treatments in treating

blood cancers and through overcoming associated limitations, will become the most effective

method of treating blood cancers.

Primarily, the journals used to collect data were clinical trials comparing two different

groups of patients with blood cancer, a group of patients administered CAR T cell therapy, and a

group of patients receiving standard of care treatments. Source 1 (“Axicabtagene Ciloleucel as

Second-Line Therapy for Large B-Cell Lymphoma,” by Locke et al.,) evaluated the effectiveness

of CAR T therapy through a phase 3 clinical trial where 180 patients received axi-cel (CAR T

cell therapy) while 179 patients received standard care, while source 2 (“Outcomes in patients

with DLBCL treated with commercial CAR T cells compared with alternate therapies,” by

Sermer et al.,) also evaluated the effectiveness of CAR T cell therapy in comparison with

alternate therapies. Results were also collected through a phase 3 clinical trial where 184 patients

were randomized. Source 3 (“Long-Term Follow-Up of CD19-CAR T-Cell Therapy in Children

and Young Adults With B-ALL,” by Shah et al.,) was a study involving a long-term follow-up of

CD-19 CAR T cell therapy in children and young adults with B-cell acute lymphoblastic

leukemia.

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Results and Data Analysis

This research is focused on highlighting CAR T cell therapy’s useful applications in

treating blood cancer in addition to its effectiveness over standard of care treatments. Extracted

information from source 1 focuses on the effectiveness of CAR T therapy through a phase 3

clinical trial where 180 patients received axi-cel (CAR T cell therapy) while 179 patients

received standard care. This article found that at 2 years, the OS (overall survival) in the axi-cel

group was higher than the OS in the standard care group, at 61% and 52% respectively. At the

median follow-up of 24.9 months, the median event-free survival was 8.3 months in the axi-cel

group and 2.0 months in the standard-care group. “A response occurred in 83% of the patients in

the axi-cel group and in 50% of those in the standard-care group (with a complete response in

65% and 32%, respectively)” (Locke et al., 2022). Additionally, during this trial, “no deaths

related to cytokine release syndrome or neurologic events occurred” (Locke et al., 2022). The

comparison between CAR T cell therapy and traditional therapies highlights CAR T cell

therapy’s effectiveness and proves why CAR T cell therapy is not only effective in treating blood

cancer, but also demonstrates its superior ability in targeting cancer over standard care

treatments.

In corroborating source 1’s findings, source 2 also evaluated and demonstrated CAR T

cell therapy’s effectiveness over standard of care treatments. This trial found that patients treated

with CAR T cell vs alternate therapies demonstrated a complete response (CR) rate of 52% vs

22% (P < .001), and the median progression-free survival (PFS) of 5.2 vs 2.3 months (P = .01)

The median overall survival (OS) of 19.3 vs 6.5 months (Sermer et al., 2020). Articles 1 and 2

both share results from clinical trials providing similar results; in both clinical trials, it was found

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that patients who received CAR T cell therapy had higher OS, CR, and median event-free

survival rates in comparison to patients in the SOC (standard of care) group. These results

support the assertion that CAR T cell therapy is i) effective in treating blood cancer, and ii) more

effective in treating blood cancers than traditional treatments.

Source 3 examines the long term effects of CAR T cell therapy in children and young

adults and found that thirty-one (62.0%) patients achieved a complete remission (CR), “28

(90.3%) of whom were minimal residual disease−negative by flow cytometry,” (Shah et al.,

2021) and at a median follow-up of 4.8 years, the median overall survival was 10.5 months (95%

CI, 6.3 to 29.2 months), (Shah et al., 2021), highlighting CAR T cell therapy’s high response

rates.

Discussion and Conclusion

CAR T cell therapy proves useful in treating patients with blood cancer and demonstrates

its effectiveness through real-world data in clinical trials. With new research in CAR T cell

therapy and cancer treatment overall, researchers hope to advance science as a whole and

discover new and innovative cancer treatment methods that have greater success in treating and

curing patients. However, there are certain limitations associated with this research and data

analysis, along with CAR T cell therapy’s applications in the real world. This meta-analysis only

analyzed three documents, which is a limited sample size. To build a stronger argument for CAR

T cell therapy, many more documents and clinical trials need to be conducted and analyzed

before scientists shift to CAR T cell therapy as a first-line of blood cancer treatment.

Additionally, CAR T cell therapy is still relatively new; the long-term effects of CAR T cell

therapy may not be evident quite yet. With more time and new research, more evidence may be

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collected to prove CAR T cell therapy’s superior ability to treat and eliminate cancer, and

advance immunotherapy treatment as a whole.

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 References

Barrell, A. (2021, March). Everything to know about CAR T cell therapy (A. Cattamanchi, Ed.).

Medical News Today. https://www.medicalnewstoday.com/articles/car-t-cell-therapy

Bartosch, J. (2019, October 17). Three years after CAR T-cell therapy for lymphoma, patient still

cancer-free. UChicago Medicine.

https://www.uchicagomedicine.org/forefront/cancer-articles/a-walking-miracle-car-t-cell-

therapy

Blood cancers. (n.d.). Cancer Treatment Centers of America.

https://www.cancercenter.com/blood-cancers

CAR T-cell therapy and its side effects. (n.d.). American Cancer Society.

https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunothe

rapy/car-t-cell1.html

Chemotherapy side effects. (n.d.). American Cancer Society.

https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemothera

py/chemotherapy-side-effects.html

Fesnak, A., & O'Doherty, U. (2017). Clinical development and manufacture of chimeric antigen

receptor T cells and the role of leukapheresis. European Oncology & Haematology,

13(01), 28. https://doi.org/10.17925/EOH.2017.13.01.28

How immunotherapy is used to treat cancer. (n.d.). American Cancer Society.

https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunothe

rapy/what-is-immunotherapy.html

How radiation therapy is used to treat cancer. (n.d.). American Cancer Society.

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 https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation/ba

sics.html

Kumar, B. V., Connors, T. J., & Farber, D. L. (2018). Human T cell development, localization,

and function throughout life. Immunity, 48(2), 202–213.

https://doi.org/10.1016/j.immuni.2018.01.007

Locke, F. L., Miklos, D. B., Jacobson, C. A., Perales, M.-A., Kersten, M.-J., Oluwole, O. O.,

Ghobadi, A., Rapoport, A. P., Mcguirk, J., Pagel, J. M., Muñoz, J., Farooq, U., Van

meerten, T., Reagan, P. M., Sureda, A., Flinn, I. W., Vandenberghe, P., Song, K. W.,

Dickinson, M., …Cheng, P. (2022). Axicabtagene ciloleucel as second-line therapy for

large b-cell lymphoma. New England Journal of Medicine, 386(7), 640-654.

https://doi.org/10.1056/NEJMoa2116133

Mäkelä, A. (2021, March). A leap forward in research on CAR T cell therapy.

https://www.eurekalert.org/news-releases/726823

Ryding, S. (2021, March). What are T cells? News Medical.

https://www.news-medical.net/health/What-are-T-Cells.aspx

Sermer, D., Batlevi, C., Palomba, M. L., Shah, G., Lin, R. J., Perales, M.-A., Scordo, M., Dahi,

P., Pennisi, M., Afuye, A., Silverberg, M. L., Ho, C., Flynn, J., Devlin, S., Caron, P.,

Hamilton, A., Hamlin, P., Horwitz, S., Joffe, E., . . . Zelenetz, A. (2020). Outcomes in

patients with DLBCL treated with commercial CAR T cells compared with alternate

therapies. Blood Advances, 4(19), 4669-4678.

https://doi.org/10.1182/bloodadvances.2020002118

Shah, N. N., Lee, D. W., Yates, B., Yuan, C. M., Shalabi, H., Martin, S., Wolters, P. L., Steinberg,

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 S. M., Baker, E. H., Delbrook, C. P., Stetler-stevenson, M., Fry, T. J., Stroncek, D. F., &

Mackall, C. L. (2021). Long-Term follow-up of cd19-car t-cell therapy in children and

young adults with b-all. Journal of Clinical Oncology, 39(15), 1650-1659.

https://doi.org/10.1200/JCO.20.02262

Sterner, R. C., & Sterner, R. M. (2021). CAR-T cell therapy: Current limitations and potential

strategies. Blood Cancer Journal, 11(4). https://doi.org/10.1038/s41408-021-00459-7

What is cancer? (n.d.). National Cancer Institute.

https://www.cancer.gov/about-cancer/understanding/what-is-cancer

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Appendix A

Article 1 Article 2 Article 3

What is found in this Effectiveness of CAR The effectiveness of The study is a

source? T therapy was CAR T cell therapy long-term follow-up
demonstrated in this in comparison with of CD-19 CAR T cell
source standard of care therapy in children
Researchers (SOC). This specific and young adults with
estimated that more trial found that B-ALL
patients treated with patients treated with Thirty-one (62.0%)
CAR T were alive CAR T cell vs patients achieved a
after 2 years than alternate therapies complete remission
those who received demonstrated a (CR), 28 (90.3%)
standard treatment. complete response Median follow-up of
“...median follow-up (CR) rate of 52% vs 4.8 years, median
of 24.9 months, the 22% (P < .001), overall survival was
median event-free median 10.5 months (95% CI,
survival was 8.3 progression-free 6.3 to 29.2 months)
months in the axi-cel survival (PFS) of 5.2
group and 2.0 months vs 2.3 months (P =
in the standard-care .01), and median
group, and the overall survival (OS)
24-month event-free of 19.3 vs 6.5
survival was 41% and months.
16%, respectively…”
At 2 years, the OS in
the axi-cel group was
higher than the OS in
the standard care
group

Methods (how was A clinical trial (phase Results were Phase I trial of
the study conducted; 3) was conducted collected from a autologous
who were the where clinical trial (phase 3) CD19.28ζ-CAR T
participants/subjects, 180 patients received where 184 patients cells in CAYAs with
etc.) axi-cel (CAR T cell were randomized relapsed or refractory
therapy) while 179 B-ALL
patients received
standard care

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What aspect of my The comparison The comparison Analyzing the
research does this between CAR T cell between CAR T cell effectivity of CAR T
help me answer? therapy and therapy and cell therapy in blood
traditional therapies, traditional therapies cancer, but also the
this source helps and proving why long term effects
prove why CAR T is CAR T is the most
the most effective for effective for blood
blood cancer cancers

Are there trends Yes, another clinical Article 1, another In this study, the
across different study (article #2) also clinical trial, also median overall
sources? demonstrated the backs the efficacy of survival (OS) was
benefit of CAR T CAR T in 10.5 months, whereas
over standard administration to in the study in article
therapies patients with blood 2, the median OS was
cancer 19.3 months

Fill in something The results of this These results help In my

from your research clinical trial help support my research conclusions/discussio
question or support my research hypothesis that CAR ns portion of my
hypothesis hypothesis in that T cell therapy will paper, I should
CAR T cell therapy become the most include that although
will become the most effective method of ⅔ of my data sources
effective method of blood cancer support my
blood cancer treatment, as this hypothesis, the results
treatment. study demonstrates of this study differ
patients having an from that of source 2.
increased complete
response rate.

Conclusions/limitatio Patients treated with Patients treated with CAR T cell therapy
ns CAR T cell therapy CAR T cell therapy can prove to have
have a better have an increased CR long-lasting results in
prognosis than rate, an increased complete remission
patients receiving median PFS, and an and median overall
standard care or increased median OS. survival.
traditional therapies

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