Before the bioengineered T-cells are reinfused, the patient undergoes a conditioning chemotherapy regimen to reduced the competing T-cell population (lymphodepletion), lower the tumor burden and help reduce serious complications such as cytokine-release syndrome (CRS).
Agents used in conditioning regimens have varied in studies but have frequently included:
- Cyclophosphamide
- A combination of fludarabine and cyclophosphamide (FC regimen) The FC regimen seems to be commonly used.
- Other agents include pentostatin and bendamustine.
Researchers note that the best conditioning regimen is still under study, but studies have shown an improved 6-month progression-free survival as well as a longer duration of CAR T-cell survival for patients who receive a preinfusion conditioning regimen. Zhang and colleagues reported that the 6-month progression free survival (PFS) was 94.6% for patients given the lymphodepletion regimen prior to cell infusion, significantly higher than 54.5% in patients without lymphodepletion.
Learn More: Adverse Events Linked With CAR T-Cell Therapy
