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ICML 2025 | Investigating the incidence of infection in patients with LBCL treated with bispecifics & CAR-T
Gloria Iacoboni, MD, PhD, Vall d’Hebron Institute of Oncology, Barcelona, Spain, presents the findings of an analysis investigating the incidence and type of infections in patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) treated with CAR T-cell therapy and bispecific antibodies. Dr Iacoboni highlights that patients exposed to both T-cell redirecting strategies had a higher cumulative incidence of infections, a factor that may be important to consider in the context of treatment sequencing in the future. This interview took place during the 18th International Conference on Malignant Lymphoma (18-ICML) in Lugano, Switzerland.
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Transcript
Yes, so this year at Lugano here at ICML 2025, we presented a poster looking at infections in both patients who received CAR T-cell therapy, autologous CD19-targeted CAR T-cells, mainly axi-cel and tisa-cel, and patients receiving treatment with CD20xCD3 targeting bispecific antibodies, both in monotherapy or in combination, commercial or in the setting of clinical trials...
Yes, so this year at Lugano here at ICML 2025, we presented a poster looking at infections in both patients who received CAR T-cell therapy, autologous CD19-targeted CAR T-cells, mainly axi-cel and tisa-cel, and patients receiving treatment with CD20xCD3 targeting bispecific antibodies, both in monotherapy or in combination, commercial or in the setting of clinical trials. So we wanted to look at the rate of infections, you know, both cumulative incidence and the type of infections where bacterial, viral, fungal, and we looked at that across our cohort of patients with relapsed/refractory large B-cell lymphoma who had received CAR-T cells or bispecifics or interestingly both products.
So we do have some patients who have been exposed to both bispecifics and CAR-T in one or another given sequence and we wanted to explore the concept that perhaps for dual receptors, those who have received both bispecifics and CAR-T, the rate of infections can be significantly higher than patients receiving only one of the T-cell redirecting modality strategies.
So we did have some exciting conclusions. We did see, you know, significant rate of infections, and I think this is going to be, you know, a growing body of data in the future. So we know all about CRS and ICANS, but I think definitely infections are sometimes not as well represented in the trial reports, not represented in detail, you know, in terms of severity, in terms of type of infection. So I think it’s very important to be looking at this for the future when, you know, sequencing is on the table and we’re deciding which way to go. Definitely, you know, the risk of cytopenias, of infections, of secondary malignancies, all of these, you know, later, let’s say adverse events are going to become key when we are selecting which given sequence we’re going to offer our treatment. So what we saw is that, in fact, patients who have been exposed to both T-cell redirecting strategies, as could be expected, had a higher risk of infection, a higher cumulative incidence of infections. And that’s something we have to look, you know, with more follow-up and larger cohorts. But it’s definitely something going to follow up in our own site and present at future meetings.
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