How to train your T cell: genetically engineered chimeric antigen receptor T cells versus bispecific T-cell engagers to target CD19 in B acute lymphoblastic leukemia

Figures & data

Table 1. Comparison of the main characteristics of blinatumomab and CART19 for the treatment of relapsing/refractory B-ALL.

	Blinatumomab [5,12]	CART19 [4,7]
Clinical results in r/r B-ALL
CR rate	30 – 69%	70 – 90%
EFS (median or at last FU)	5.9 – 7.6 months	66% (at 6 months)
OS (median or at last FU)	6.1 – 9.8 months	51.6 (at 9.7 months) – 78% (at 6 months)
MRD-negative CR (% of CR)	63 – 69%	60 – 88%
Severe CRS (grade 3 – 4)	2 – 6%	27 – 28%
Other grade ≥ 3 AES	Encephalopathy, B-cell aplasia	Encephalopathy, B-cell aplasia
Long-term antitumor effect	Few patients (most received ASCT)	Multiple patients
Advantages	Off-the-shelf, predictable PK, known dose–response, able to turn off at will	Long-lasting effect after a single infusion, no need for months of onerous continuous infusion
Disadvantages	Continuous infusion via central line; theoretical induction of peripheral tolerance due to recruitment of Tregs	Personalized therapy; intensive manufacturing process; long-term follow-up required given use of lenti- or retroviral techniques

ASCT: Allogeneic stem-cell transplantation; CRS: Cytokine-release syndrome; PK: Pharmacokinetic.