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<p>Brexucabtagene autoleucel (brexu-cel) is an autologous CD19-directed CAR T-cell therapy approved for relapsed/refractory (R/R) mantle cell lymphoma (MCL) based on the pilot study ZUMA-2. Since then, several US and European real-world studies have demonstrated comparable efficacy outcomes. However, these reports have also suggested potentially higher rates of acute toxicities, particularly immune effector cell–associated neurotoxicity syndrome (ICANS), raising concerns regarding its use, especially in vulnerable populations. At Singapore General Hospital, five patients (median age 75 years) received brexu-cel from April 2025 to Dec 2025 for R/R MCL. Historical cohort MCL patients received allogeneic haematopoietic stem cell transplantation (allo-HSCT) were extracted and compared. For brexu-cel cohort, the overall response rate (ORR) was 100%, with a complete response rate (CRR) of 80%. Cytokine release syndrome (CRS) occurred in 80% of patients, with no grade 3 events, and only one patient developed grade 1 ICANS (20%). These efficacy and safety outcomes compare favourably with historical cohorts of patients who underwent allo-HSCT locally (total 6 patients, 2 relapsed, 2 NRM), despite potentially higher-risk features and less controlled disease at baseline. Efficacy and toxicity of both clinical trial and real-world CAR-T studies for R/R MCL were summarized. To our knowledge, this represents the first real-world report from Asia on brexu-cel in R/R MCL, supporting its use in this region, where published data have thus far predominantly originated from the United States and Europe.</p>

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Brexucabtagene autoleucel for relapsed/refractory mantle cell lymphoma in asia: redefining the role of allogeneic haematopoietic stem cell transplantation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Lawrence Cheng Kiat Ng,
  • Jing Yuan Tan,
  • Shin Yeu Ong,
  • Chandramouli Nagarajan,
  • Michelle Li Mei Poon,
  • Aloysius Yew Leng Ho,
  • Francesca Wei Inng Lim,
  • Yunxin Chen

摘要

Brexucabtagene autoleucel (brexu-cel) is an autologous CD19-directed CAR T-cell therapy approved for relapsed/refractory (R/R) mantle cell lymphoma (MCL) based on the pilot study ZUMA-2. Since then, several US and European real-world studies have demonstrated comparable efficacy outcomes. However, these reports have also suggested potentially higher rates of acute toxicities, particularly immune effector cell–associated neurotoxicity syndrome (ICANS), raising concerns regarding its use, especially in vulnerable populations. At Singapore General Hospital, five patients (median age 75 years) received brexu-cel from April 2025 to Dec 2025 for R/R MCL. Historical cohort MCL patients received allogeneic haematopoietic stem cell transplantation (allo-HSCT) were extracted and compared. For brexu-cel cohort, the overall response rate (ORR) was 100%, with a complete response rate (CRR) of 80%. Cytokine release syndrome (CRS) occurred in 80% of patients, with no grade 3 events, and only one patient developed grade 1 ICANS (20%). These efficacy and safety outcomes compare favourably with historical cohorts of patients who underwent allo-HSCT locally (total 6 patients, 2 relapsed, 2 NRM), despite potentially higher-risk features and less controlled disease at baseline. Efficacy and toxicity of both clinical trial and real-world CAR-T studies for R/R MCL were summarized. To our knowledge, this represents the first real-world report from Asia on brexu-cel in R/R MCL, supporting its use in this region, where published data have thus far predominantly originated from the United States and Europe.