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ASH 2024 | How to best manage first relapse in DLBCL outside of CAR-T
Wendy Osborne, MBBS (Hons), MRCP, FRCPath, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK, comments on the potential of bispecific antibodies to improve outcomes for patients with second-line diffuse large B-cell lymphoma (DLBCL) outside of CAR T-cell therapy. Dr Osborne highlights the promising results from the STARGLO trial (NCT04408638), which showed a significant progression-free survival (PFS) and overall survival (OS) benefit for patients treated with glofitamab plus gemcitabine and oxaliplatin (Glofit-GemOx) compared to rituximab-GemOx, and notes that this approach may be licensed and approved for those patients unfit for autologous stem cell transplantation (autoSCT). This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
So we had a symposium on Friday focusing on second-line diffuse large B-cell lymphoma patients outside of CAR-T and really the focus thinking about where bispecific antibodies can fit in. So this was alongside Gilles Salles and Gareth Gregory and we also had Natasha Bolaños with us who was from the Lymphoma Coalition who presented really interesting data from the patient survey understanding about how we can actually improve our shared decision-making with our patients...
So we had a symposium on Friday focusing on second-line diffuse large B-cell lymphoma patients outside of CAR-T and really the focus thinking about where bispecific antibodies can fit in. So this was alongside Gilles Salles and Gareth Gregory and we also had Natasha Bolaños with us who was from the Lymphoma Coalition who presented really interesting data from the patient survey understanding about how we can actually improve our shared decision-making with our patients.
So we looked at the data that we currently have for second line outcomes for patients and also the data in bispecific antibodies, particularly the STARGLO data. So the STARGLO data showing that patients who were randomized to Glofitamab-GemOx, compared to GemOx actually had not only a PFS benefit but a significant overall survival benefit. And the StarGlow cohort is an auto-ineligible group of patients, so different to the current second line auto-eligible as per ZUMA-7 where we currently use axi-cel second line for our auto-eligible patients in the UK. Liso-cel is being discussed by NICE at the moment, so it’s possible that in the future we’ll also have liso-cel second line for patients in the UK.
But for the auto-unfit population, I think that we are hoping that a STARGLO approach with Glofitamab-GemOx may go and get licensed and then hopefully subsequent approval.
And we also looked at other bispecific antibodies. There are ongoing studies looking at the second line space with epcoritamab in combination with lenalidomide, and I think that’s going to be very interesting data. And what we’re hoping is that maybe with these new data and new opportunities, maybe we will not have to always do an autologous stem cell transplant for some people. Maybe we can either select cellular therapy or bispecific antibody therapy to try and improve the outcomes for our patients.
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Disclosures
Honoraria: Roche, Takeda, Pfizer, Kite Gilead, Astra Zeneca, Novartis, Kyowa Kirin, Incyte, Janssen, BMS; Membership on an entity’s Board of Directors or advisory committees: Roche, Takeda, Kite Gilead, Kyowa Kirin, Servier, Incyte, Janssen, BMS, MSD, Beigene, Autolus, Sobi, Syneos.
