Additional possibilities of chimeric antigen receptor T-cells in B-cell lymphoma: combination therapy

B-cell non-Hodgkin's lymphoma (B-NHL) is a lymphoproliferative disorder that affects B lymphocytes. Chimeric antigen receptor (CAR) T-cell immunotherapy is a new type of immunotherapy that uses genetic engineering techniques to modify and expand the patient's autoimmune cells in vitro, after which these cells are reinfused into the patient. CAR-T cell immunotherapy has the potential to treat different types of B-cell lymphoma. Many clinical studies have shown that CAR-T cell therapy has significant antitumor effects on B-cell lymphoma. Although much work has been carried out to improve the efficacy of CAR-T cell therapy and to reduce associated side effects, there are still many issues to address. CAR-T cell therapy shows significant promise in treating B-NHL, but some patients still have a poor initial response to this therapy where the infused CAR-T cells show insufficient persistence. With the rapid development of immunological therapy, combination therapy has been certified to improve the efficacy of CAR-T cell therapy. Targeted drugs such as programmed death-1 (PD-1) inhibitors, programmed cell death-ligand 1 (PD-L1) inhibitors, and Bruton's tyrosine kinase (BTK) inhibitors may further enhance the efficacy and reduce the side effects of CAR-T cell treatment. This article reviews the rationale and relevant clinical research on combination therapy based on CAR-T cell therapy for B-cell lymphoma treatment.