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 8 products (8 approved), 13 trials, 2 pathways and 3 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.
Biology
B-cell co-receptor; loss of CD19 is a common escape mechanism after CAR-T.
- ALL
- DLBCL
- Follicular lymphoma
- Mantle cell lymphoma
- CLL
Elsewhere: identifiers and databases
Built from HGNC, Ensembl, UniProt and ChEMBL idsHow common it is, by cancer
Full matrix →| 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.
Products by modality and phase
Browse products →| Modality | Approved |
|---|---|
| Cell therapy 5 | |
| ADC 1 | |
| Antibody 1 | |
| T-cell engager 1 |
Trials
Evidence ranking →| Trial | Phase | Status | Setting | Result | Products |
|---|---|---|---|---|---|
| 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%. | |
| 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. | |
| LOTIS-2 NCT03589469 | 2 | Positive | R/R DLBCL after ≥2 lines: loncastuximab tesirine (single arm) | ORR 48%, CR 24%. | |
| 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%. | |
| ELIANA NCT02435849 | 2 | Positive | Relapsed or refractory B-ALL, patients aged 3-25: single infusion of tisagenlecleucel | ORR 81%; 12-month OS 76%; 5-year OS 55%. | |
| FELIX NCT04404660 | 1/2 | Positive | Relapsed or refractory B-ALL, adults: obecabtagene autoleucel single split-dose course | ORR 77%, CR 55%; grade ≥3 CRS 2.4%. | |
| TRANSCEND CLL 004 NCT03331198 | 1/2 | Positive | Relapsed/refractory CLL/SLL after BTK inhibitor (and venetoclax in the primary analysis set): lisocabtagene maraleucel | CR/CRi 18-20%; ORR 47%; uMRD blood 64%. |
Resistance routes that involve this target
Unaddressed routes →Alternative splicing, mutation, or lineage switch (to myeloid) removes the CD19 epitope.
- CD22 CAR-T, CD20 bispecifics, dual-target CARs
Limited expansion or early loss of CAR-T cells; 4-1BB products persist longer than CD28.
- Allogeneic or in vivo re-dosing; armoured CARs
PD-1 upregulation, TGF-β, and myeloid suppression in lymphoma.
- PD-1 knockout or blockade with CAR-T (trials)
Pathways where it is a node
Pathway-to-drug matrix →- Resistance routes: how a blocked pathway comes backNode: 5 Efflux, sanctuary, antigen loss · 6 druggable nodes
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-cell exhaustionNode: CAR-T exhaustion · 3 druggable nodes
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 →
Companion diagnostics and assays
Assay registry →No companion diagnostic in the registry measures this target.
Preclinical models
All models →| 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. |
- Eμ-Myc (Myc transgene) Adams et al., Nature 1985
Open questions
All open questions →- 01
Can in vivo CAR-T (lentiviral or mRNA delivery of the CAR to the patient's own T cells) match ex vivo products in B-cell malignancies?
translationalindustryWhy 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.
Source: ZUMA-1, NEJM 2017
Ideas and companies
Key papers and the live literature
Preprints →- Children's Oncology Group AALL1731: blinatumomab added to chemotherapy for children with standard-risk B-cell ALL · New England Journal of Medicine 2025
- ECOG-ACRIN E1910: adding blinatumomab to chemotherapy for adults with B-cell ALL already in MRD-negative remission · New England Journal of Medicine 2024
- TRANSFORM: liso-cel CAR-T versus salvage chemotherapy and transplant in early-relapsing large B-cell lymphoma · The Lancet 2022
- ZUMA-7: axi-cel CAR-T instead of salvage chemotherapy and transplant for large B-cell lymphoma that relapses early · New England Journal of Medicine 2022
- UCART19: the first gene-edited, donor-derived CAR-T cells in children and adults with relapsed B-cell ALL · The Lancet 2020
- ZUMA-2: brexu-cel CAR-T for mantle cell lymphoma that has failed BTK inhibitors · New England Journal of Medicine 2020
- JULIET: tisagenlecleucel for adults with relapsed or refractory diffuse large B-cell lymphoma · New England Journal of Medicine 2019
- ELIANA: the global trial that made tisagenlecleucel the first approved CAR-T therapy for children and young adults with relapsed ALL · New England Journal of Medicine 2018
- ZUMA-1: axicabtagene ciloleucel for refractory large B-cell lymphoma, the first CAR-T approved for lymphoma · New England Journal of Medicine 2017
- Maude 2014: CD19 CAR-T cells produce complete remission in 27 of 30 children and adults with relapsed ALL · New England Journal of Medicine 2014
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.
Export
The dossier as machine-readable 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 4.0.