Tisagenlecleucel is indicated for pediatric and young adult patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL) and adult patients with r/r diffuse large B-cell lymphoma (DLBCL). The tisagenlecleucel chimeric antigen receptor (CAR) contains a murine single-chain variable fragment domain; hence, we examined the effects of humoral and cellular immune responses to tisagenlecleucel on clinical outcomes using 2 validated assays. Data were pooled from ELIANA (NCT02435849) and ENSIGN (NCT02228096) trials in r/r B-ALL (N=143) and the JULIET trial (NCT02445248) in r/r DLBCL (N=115). Humoral responses were determined by flow cytometric measurement of anti-murine CAR19 (mCAR19) antibodies in serum. Cellular responses were determined using T-cell production of interferon gamma in response to 2 different pools of mCAR19 peptides. Pretreatment anti-mCAR19 antibodies were detected in 81% of patients with r/r B-ALL and 94% of patients with r/r DLBCL. Posttreatment anti-mCAR19 antibodies were higher than patient-specific baseline in 42% of r/r B-ALL and 9% of r/r DLBCL patients. Pretreatment and posttreatment anti-mCAR19 antibodies did not affect tisagenlecleucel cellular kinetics including Cmax and persistence (r2<0.05), clinical response (day 28 response, duration of response, event-free survival), or safety. T-cell responses were consistent over time, with net responses <1% at baseline and posttreatment time points in the majority of patients with no effect on transgene expansion and persistence or outcomes. Presence of baseline and/or posttreatment anti-mCAR19 antibodies or T-cell responses did not alter the activity of tisagenlecleucel in patients with r/r B-ALL or r/r DLBCL.

Author Info: (1) Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States. (2) University of Pennsylvania, United States. (3) University of Pennsylvania, United States. (4) University of Michigan, United States. (5) Children's Hospital Los Angeles/USC Keck School of Medicine, Los Angeles, California, United States. (6) University of Utah, Salt Lake City, Utah, United States. (7) Children's Mercy Hospital, Kansas City, Missouri, United States. (8) Children's Mercy Hospital, Kansas City, Missouri, United States. (9) Peter MacCallum Cancer Center and The University of Melbourne, Melbourne, Australia. (10) Medical University of Vienna, Vienna, Austria. (11) McMaster University, Hamilton, Canada. (12) Uniklinik Koeln, Koeln, Germany. (13) University of Pennsylvania, Philadelphia, Pennsylvania, United States. (14) Winship Cancer Institute, Atlanta, Georgia, United States. (15) Novartis Institutes for BioMedical Research, East Hanover, New Jersey, United States. (16) Novartis Pharma AG, Basel, Switzerland. (17) Salt River Integrated Bioanalysis GmbH, Basel, Switzerland. (18) Novartis, East Hanover, New Jersey, United States. (19) Novartis Pharma AG, Basel, Switzerland. (20) Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States. (21) Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.