[Current and future perspectives on CAR-T cell therapy to adult malignant lymphoma]

Recent advances with chimeric antigen receptor T-cell (CAR-T) therapy are changing the current landscape of poor-prognosis relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). Pivotal trials leading to the FDA approval of three CD19 CAR-T cells, namely, Yescarta^®, Kymriah^®, and Breyanzi^®, demonstrated complete response rates of 40-60%, with a significant subset of patients achieving long-term disease remission, and real-world studies confirm these data. In Japan, CAR-T therapy was approved for R/R DLBCL in 2019 and for R/R follicular lymphoma in 2022. However, guidelines are not clear on which CAR-T agents should be indicated for which patients and at which timing, and currently, institutions decide and operate according to their criteria. To optimize CAR-T therapy under the best conditions, the treatment strategy must be decided with the referring institution in terms of T-cell fitness and tumor volume. Therefore, institutional collaboration to monitor long-term adverse events after CAR-T therapy is important.