How would you manage relapsed DLBCL in a patient who received second line CD19 CART treatment?

With commercial CD19 CAR-T therapy moving into earlier lines of therapy, post-CAR-T relapses are now more common. There are still many options depending on what first-line/bridging therapy was given, CD19/20/30 expression, and patient preferences. I always get a biopsy if feasible to confirm relapse...

Since data suggests that at least 50% of relapses after CD19 CAR-T are related to loss of CD19 antigen, I would avoid using any CD19 targeting antibody (Loncastuximab tesirine or tafasitamab). I would also avoid using cytotoxic chemotherapy because the vast majority of such patients have chemorefrac...

There are many currently FDA-approved treatments for relapsed and refractory diffuse large B-cell lymphoma. Many of these treatments target specific markers on the surface of the lymphoma cells, so where possible, I try to biopsy patients following CAR T relapse. Typically, if the marker CD20 is pre...