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ICML 2025 | How the use of personalized medicine is evolving within the field of lymphoma
In this video, Ash Alizadeh, MD, PhD, Stanford University, Stanford, CA, comments on the evolution of personalized medicine in lymphoma, highlighting the importance of patient selection, risk assessment, and mitigation of secondary consequences. He notes that clinical studies are exploring the use of off-the-shelf allogeneic CAR T-cells and liquid biopsies, including ctDNA, to monitor disease progression, treatment efficacy, and toxicity. This interview took place during the 18th International Conference on Malignant Lymphoma (18-ICML) in Lugano, Switzerland.
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Transcript
One strategy is patient selection for treatment and now there are a number of clinical studies. The biggest one that’s been announced is a randomized trial of using off-the-shelf allogeneic CAR T-cells in the ALPHA3 trial using cema-cel for patients with detectable ctDNA after curative intent frontline therapy who are then randomized to see if early adoption of widely available largely outpatient therapy over observation would afford an advantage...
One strategy is patient selection for treatment and now there are a number of clinical studies. The biggest one that’s been announced is a randomized trial of using off-the-shelf allogeneic CAR T-cells in the ALPHA3 trial using cema-cel for patients with detectable ctDNA after curative intent frontline therapy who are then randomized to see if early adoption of widely available largely outpatient therapy over observation would afford an advantage. So for patient selection the other is to look at determinants of risk over the course of therapy. Do genetic mutations that predict failure emerge? And is the therapy working or not, like in the liso-cel study. And then a third area is work around how secondary unintended consequences of CAR T-cells may be mitigating, in particular in patients with toxicities that can be exaggerated. For example, infectious toxicities in patients who have pre-existing evidence of clonal hematopoiesis that under selection of CAR T-cells can lead to infectious complications. So can ctDNA monitor small CH clones that are not cancer, they are pre-cancers, they put some at risk of secondary myeloid malignancies but also infectious complications. So those are some different applications of liquid biopsies for detecting disease to treat and to monitor the efficacy of the treatment and the toxicity of the treatment.
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