CAR-T Meeting 2023 | Updates on the use of CAR-T therapy in mantle cell lymphoma and follicular lymphoma
In this video, Ulrich Jäger, MD, Medical University of Vienna, Vienna, Austria, shares some insights into the role of CAR-T therapy in mantle cell lymphoma (MCL) and follicular lymphoma (FL). Prof. Jäger first discusses updates in MCL, highlighting the approval of brexucabtagene autoleucel (brexu-cel) in the relapsed/refractory (R/R) setting. Following this, Prof. Jäger discusses challenges and updates in FL, and further comments on the possibility of combining CAR-T cells with novel bispecific antibodies.This interview took place at the EBMT-EHA 5th European CAR T-cell Meeting held in Rotterdam, The Netherlands.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript (edited for clarity)
I was given the complicated task of talking about two lymphomas in 15 minutes in a speed update, but it’s really not that bad because there are very exciting data. So in mantle cell lymphoma, of course we have a span of different variations of the mantle cell lymphoma, and we have also the span between patients who can go onto transplant now with the current standard of care in first line, to patients who only receive supportive treatment for their lymphoma...
I was given the complicated task of talking about two lymphomas in 15 minutes in a speed update, but it’s really not that bad because there are very exciting data. So in mantle cell lymphoma, of course we have a span of different variations of the mantle cell lymphoma, and we have also the span between patients who can go onto transplant now with the current standard of care in first line, to patients who only receive supportive treatment for their lymphoma.
And the CARs will certainly change our world. There is the brexu-cel already approved, and the data are really exciting with extremely high response rates and very good, more than 50% progression-free survival and good long-term survival. The question that’s pertinent now is really, “can we use CAR-T cells in first line as a consolidation treatment substituting for autologous stem cell transplant? And what’s the role in, let’s say, elderly, more frail patients?” And then, the treatment landscape is complicated because other agents, like bispecific antibodies, are moving into the field, and currently, we don’t really know if they can substitute for CARs, or, which is my favorite approach, can we combine, for instance, these novel agents together with CARs? So I think very exciting data for the mantle cell lymphoma.
For the follicular lymphoma, it’s kind of similar. We have two approved products from the ZUMA-5 and ELARA trials, and both of them are extremely effective. We have some real-world experience also for that on that subject, which shows and confirms their activity. But again, they are effective in all subgroups. The problematic group there is the progression of disease within 24 months, POD24 group. They are effective there, but we could do a little better. So again, it’s the question, “what is the role of the bispecifics, which are moving into the treatment landscape, and can we combine them? And can the CAR-T cells substitute for autologous stem cell transplant in first relapse?” And there is even a trial that compares that in a randomized fashion.
Read more...
