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CD19 is a marker on B cells and B-cell cancers, and was the target of the first CAR-T therapies ever approved. This dossier gathers the 26 products (12 approved), 76 trials, 2 pathways and 5 resistance routes in the corpus that involve it, with external identifiers so it can be joined to UniProt, ChEMBL, Open Targets and the rest of biology.
B-cell co-receptor; loss of CD19 is a common escape mechanism after CAR-T.
| Cancer | Prevalence | Measure | Note | Source |
|---|---|---|---|---|
| Acute lymphoblastic leukaemia | >95% | B-ALL surface expression | Wikipedia | |
| Diffuse large B-cell lymphoma | >95% | Surface expression | Loss in ~30% of CAR-T relapses | Wikipedia |
| Chronic lymphocytic leukaemia | >95% | Surface expression | Wikipedia |
Approximate, population-level figures; the measure column says what was counted. Ranges show the midpoint as a bar.
| Modality | Approved | Phase 3 | Phase 2 |
|---|---|---|---|
| Cell therapy 20 | |||
| Bispecific antibody 2 | - | - | |
| ADC 1 | - | - | |
| Antibody 1 | - | - | |
| fusion protein 1 | - | - | |
| T-cell engager 1 | - | - |
| Trial | Setting | Result | Products | ||
|---|---|---|---|---|---|
| 3 | Active | A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate the Efficacy and Safety of Tafasitamab Plus Lenalidomide in Addition to Rituximab Versus Lenalidomide in Addition to Rituximab in Patients With Relapsed/Refractory (R/R) Follicular Lymphoma Grade 1 to 3a or R/R Marginal Zone Lymphoma | Median investigator-assessed progression-free survival 22.4 against 13.9 months (hazard ratio 0.43, 95 per cent confidence interval 0.32 to 0.58). | ||
frontMIND NCT04824092 | 3 | Positive | Untreated high-risk DLBCL (IPI 3-5): tafasitamab + lenalidomide + R-CHOP vs placebo + R-CHOP | PFS HR 0.75; 2-year PFS 71.1% vs 62.9%. | |
COG AALL1731 NCT03914625 | 3 | Positive | Newly diagnosed standard-risk B-ALL in children: two cycles of blinatumomab added to chemotherapy vs chemotherapy alone | 3-year DFS 96.0% vs 87.9%; HR 0.39. | |
ECOG-ACRIN E1910 NCT02003222 | 3 | Positive | Newly diagnosed Ph-negative B-ALL, age 30-70, in MRD-negative remission after induction: blinatumomab added to consolidation chemotherapy vs chemotherapy alone | 3-year OS 85% vs 68%; HR 0.41. | |
TRANSFORM NCT03575351 | 3 | Positive | Primary refractory or early-relapsed LBCL, transplant-eligible: liso-cel vs salvage + autologous transplant | EFS HR 0.36; CR 74% vs 43%. | - |
AALL1331 NCT02101853 | 3 | Mixed | Children, adolescents and young adults aged 1 to 30 with a first relapse of B-cell acute lymphoblastic leukaemia: after one block of reinduction chemotherapy, blinatumomab in place of intensive consolidation chemotherapy (high and intermediate risk, then transplant) or intercalated with chemotherapy (low risk) | Blinatumomab consolidation gave two-year disease-free survival of 54.4 percent against 39.0 percent with chemotherapy in high- and intermediate-risk relapse (not statistically significant after early closure), with better overall survival and far less toxicity; in low-risk bone marrow relapse it improved disease-free and overall survival. | |
ZUMA-7 NCT03391466 | 3 | Positive | Large B-cell lymphoma refractory or relapsed within 12 months of frontline therapy: axi-cel vs salvage chemotherapy + autologous transplant | EFS HR 0.40; OS HR 0.73; 4-year OS 54.6% vs 46.0%. | |
Interfant-06 NCT00550992 | 3 | Mixed | Infant ALL (<1 year): standard vs AML-type early intensification; transplant for high-risk KMT2A-rearranged infants | 6-year EFS 46.1%; intensification no benefit. | |
TOWER NCT02013167 | 3 | Positive | Relapsed or refractory Ph-negative B-ALL, adults: blinatumomab vs standard salvage chemotherapy | OS 7.7 vs 4.0 months; HR 0.71. | |
| 3 | Active | A Randomized, Open-label, Multi-center Phase III Trial Comparing Tisagenlecleucel to Standard of Care in Adult Participants With Relapsed or Refractory Follicular Lymphoma (FL) | - | ||
| 3 | Recruiting | A Phase III, Multicentre, Randomised, Open-label Study to Compare the Efficacy and Safety of AZD0486 Plus Rituximab Versus Chemotherapy Plus Rituximab in Previously Untreated Participants With Follicular Lymphoma (SOUNDTRACK-F1) | - | ||
| 3 | Recruiting | A Phase 3 Randomized Controlled Trial of Rondecabtagene Autoleucel, an Autologous, Dual-targeting CD19/CD20 CAR T-Cell Product Candidate, Vs. Investigator's Choice of CD19 CAR T-Cell Therapy in Patients With Relapsed or Refractory Large B-Cell Lymphoma in the Second-line Setting | - | ||
| 3 | Recruiting | A Phase III, Multicentre, Open-Label, Randomised Study Evaluating the Efficacy and Safety of R-mini-CHOP x2 Followed by AZD0486 Versus R-mini-CHOP x6 in Elderly or Unfit Participants With Newly Diagnosed Large B-cell Lymphoma (SOUNDTRACK-D2) | - | ||
IntReALL SR 2010 NCT01802814 | 3 | Completed | Children with a standard-risk first relapse of acute lymphoblastic leukaemia across the International BFM Study Group: a first randomisation between the ALL-REZ BFM 2002 and UK ALL R3 induction and consolidation programmes, and a second randomisation adding the anti-CD22 antibody epratuzumab to consolidation | - | |
| 3 | Active | A Phase 3 Randomized, Open-Label, Multicenter Study Evaluating the Efficacy of Axicabtagene Ciloleucel Versus Standard of Care Therapy in Subjects With Relapsed/Refractory Follicular Lymphoma | - | ||
| 3 | Recruiting | A Phase IIIb Study of the Safety and Efficacy of Tisagenlecleucel Out of Specification for Commercial Release in Patients Who Are Consistent With the Label Indication | - | ||
| 3 | Active | A Phase 3 Randomized Study of Loncastuximab Tesirine Combined With Rituximab Versus Immunochemotherapy in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma (DLBCL) (LOTIS-5) | - | ||
| 3 | Active | A Phase 3, Single-Arm, Open-Label, Multicenter Study to Evaluate the Safety and Efficacy of Tafasitamab Plus Lenalidomide in Participants With Relapsed or Refractory Diffuse Large B-Cell Lymphoma | - | ||
| 3 | Recruiting | A Phase III, Randomised, Open-label, Multicentre, Study of Surovatamig as Consolidation Therapy Versus Observation After First-line Induction Therapy in Participants With Chronic Lymphocytic Leukaemia or Small Lymphocytic Lymphoma With Unmutated IGHV (SOUNDTRACK-C1) | - | ||
| 2/3 | Recruiting | A Phase 2/3 Randomized, Open-label Study of MK-1045 in Combination With Rituximab in Participants With 1L Follicular Lymphoma | - | ||
| 2/3 | Recruiting | A Phase 2/3, Randomized, Open-Label, Comparison Study of MK-1045 Versus Blinatumomab in Participants With Relapsed or Refractory CD19+ B-Cell Acute Lymphoblastic Leukemia (B-ALL) | - | ||
| IMAGINE (varnimcabtagene autoleucel, Immuneel) | 2 | Positive | Relapsed or refractory B-cell malignancies (B-cell non-Hodgkin lymphoma and B-ALL), adults, India | - | |
ELARA NCT03568461 | 2 | Positive | Relapsed or refractory follicular lymphoma after two or more lines, or relapsing after an autologous transplant: a single infusion of tisagenlecleucel | Complete response in 69.1 per cent and overall response in 86.2 per cent, with no grade 3 or worse cytokine release syndrome and no treatment-related deaths. | |
LOTIS-2 NCT03589469 | 2 | Positive | R/R DLBCL after ≥2 lines: loncastuximab tesirine (single arm) | ORR 48%, CR 24%. | |
| RELIANCE | 2 | Positive | Relapsed or refractory large B-cell lymphoma after two or more lines, China: single-arm pivotal study of relmacabtagene autoleucel at two dose levels | ORR 75.9%, CR 51.7%. | |
ZUMA-5 NCT03105336 | 2 | Positive | Relapsed or refractory follicular or marginal zone lymphoma after two or more lines of therapy: single-arm axicabtagene ciloleucel CAR-T | High objective and complete response rates in relapsed follicular lymphoma with durable remissions; accelerated approval in March 2021. | |
D-ALBA (GIMEMA LAL2116) NCT02744768 | 2 | Positive | Newly diagnosed Ph-positive ALL, adults of all ages: dasatinib induction followed by blinatumomab, no systemic chemotherapy | 18-month OS 95%, DFS 88%. | |
L-MIND NCT02399085 | 2 | Positive | R/R DLBCL, transplant-ineligible, 1-3 prior lines: tafasitamab + lenalidomide (single arm) | ORR 60%, CR 43%. | |
ZUMA-2 NCT02601313 | 2 | Positive | Relapsed or refractory mantle cell lymphoma after a BTK inhibitor: single-arm brexucabtagene autoleucel CAR-T | High objective and complete response rates with durable remissions in mantle cell lymphoma after BTK inhibitor failure; approved in July 2020. | |
JULIET NCT02445248 | 2 | Positive | Relapsed or refractory diffuse large B-cell lymphoma after two or more lines, or after an autologous transplant: a single infusion of tisagenlecleucel | A pivotal single-arm study supporting the approval of tisagenlecleucel in relapsed or refractory large B-cell lymphoma after two or more lines. |
Alternative splicing, mutation, or lineage switch (to myeloid) removes the CD19 epitope.
Limited expansion or early loss of CAR-T cells; 4-1BB products persist longer than CD28.
PD-1 upregulation, TGF-β, and myeloid suppression in lymphoma.
Transcriptional down-regulation of MS4A1 rather than deletion: CD20 messenger RNA is lower in the negative cells than in the positive cells from the same patient.
The CD20 arm fails for the same reasons rituximab does: transcriptional down-regulation and shaving.
When a drug blocks a cancer's engine, the cancer has five ways back: change the part the drug binds, make more of it, take a side road, switch to a different engine altogether, or stop letting the drug in. Knowing which route a tumour took decides the next drug.
Which nodes have drugs →T cells that see their target for weeks on end without winning gradually shut down: they raise a set of brakes (PD-1, LAG-3, TIM-3, TIGIT), lose their ability to kill, and eventually lock this state into their DNA. Checkpoint drugs rescue the ones that are only partly exhausted; the terminally exhausted are beyond reach.
Which nodes have drugs →No companion diagnostic in the registry measures this target.
| Cell line | Identifiers | Why it is used |
|---|---|---|
| NALM-6 | CVCL_0092 · ACH-000938 | Pre-B ALL; CAR-T potency standard. |
| Raji | CVCL_0511 · ACH-000654 | Burkitt; CD19 and CD20. |
| Daudi | CVCL_0008 · ACH-000786 | Burkitt; beta-2-microglobulin null (no HLA class I), useful for MHC-independent killing. |
| REH | CVCL_1650 · ACH-000960 | Pre-B ALL. |
| JeKo-1 | CVCL_1865 · ACH-000357 | Mantle-cell lymphoma. |
| K-562 CD19 | not resolved | CD19-transduced K-562 as an artificial target with CD19-negative parent as control. |
Why unresolved. Manufacturing cost, slot limits and vein-to-vein time are the main barriers to CD19 CAR-T access; in vivo approaches remove them but first-in-human data are only now emerging.
What would answer it. Phase 1/2 data showing comparable expansion, persistence and complete-response rates, then a randomised comparison with an approved product.
Query for this target: (TITLE:"CD19" OR ABSTRACT:"CD19") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about CD19, not a curated reading list.
The dossier as machine-readable JSON, at /api/v1/dossiers/cd19.json: identifiers from HGNC, Ensembl, UniProt and ChEMBL, products with status, trials, pathways, hotspots, open questions and assays. The full entity record is in the open API at /api/v1/entities/cd19.json. Licence CC BY-NC 4.0.