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ASH 2021 | Second-line CAR-T therapy in B-cell lymphoma

Peter M. Riedell, MD, University of Chicago Medicine, Chicago, IL, shares updates from the Phase III ZUMA-7 trial (NCT03391466) of the anti CD19 axicabtagene ciloleucel (axi-cel), a chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed/refractory (r/r) large B-cell lymphoma (LBCL). A superior event-free survival and overall survival were reported in the axi-cel arm and the findings corroborate with data from the Phase III TRANSFORM trial (NCT03575351), demonstrating the potential of CAR T-cell therapy as a second-line option for LBCL. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.

Transcript (edited for clarity)

We participated in ZUMA-7, which was a large, multi-institutional study evaluating axicabtagene ciloleucel in the second-line setting compared to salvage chemotherapy and autologous stem cell transplants. And that study, I think showed some pretty interesting findings. Particularly, I think one of the things to highlight is the fraction of patients who actually were able to move on to autologous stem cell transplant, which was about one in three patients, which was I think sort of in line with some of the prior data, but certainly shows how high risk and aggressive that patient population is...

We participated in ZUMA-7, which was a large, multi-institutional study evaluating axicabtagene ciloleucel in the second-line setting compared to salvage chemotherapy and autologous stem cell transplants. And that study, I think showed some pretty interesting findings. Particularly, I think one of the things to highlight is the fraction of patients who actually were able to move on to autologous stem cell transplant, which was about one in three patients, which was I think sort of in line with some of the prior data, but certainly shows how high risk and aggressive that patient population is.

At the end of the day, the results would suggest that there are improvements in event-free survival and there is some also suggestion of an improvement in overall survival based on patients that moved to the axi-cel arm immediately after failing initial frontline therapy, as opposed to those that received it later and received autotransplant and potentially CAR-T afterwards. And then I think the other thing that’s in my eyes important is that we saw, I would say results from the TRANSFORM study, which were relatively in line with some of the findings of that study. So I think it certainly does increase the generalizability of that and potentially paint a picture where we can see the use of CAR T-cell therapy in the second-line setting.

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