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ASH 2025 | Impact of bridging therapy on efficacy of CD19 CAR T-cell therapy in DLBCL
In this video, Fabian Müller, MD, University Hospital Erlangen, Erlangen, Germany, discusses the impact of bridging therapy on the efficacy of CD19 CAR T-cell therapy in diffuse large B-cell lymphoma (DLBCL), highlighting that both histology and choice of bridging therapy influence clinical outcomes. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
Since I’m a hemato-oncologist by training, obviously the autoimmune field is very interesting to us, but we’re also very much interested in our standard of care CAR T-cell therapy outcome in the end. And something that is totally understudied that we have been studying from a couple of different angles is the effects of bridging. So what we already know is that a patient who is responding to bridging is going to do better...
Since I’m a hemato-oncologist by training, obviously the autoimmune field is very interesting to us, but we’re also very much interested in our standard of care CAR T-cell therapy outcome in the end. And something that is totally understudied that we have been studying from a couple of different angles is the effects of bridging. So what we already know is that a patient who is responding to bridging is going to do better. There’s plenty of data on that. And then obviously, if you have a stronger bridging, the patient is potentially doing better down the road. So we are always looking at time from infusion with the CARs and then what the CAR outcome is in the long run.
And the problem is always that a patient that I’m not bridging is phenotypically just very different from a patient that has a more aggressive disease where I decide as a doctor here I need bridging, the other patient I potentially don’t need bridging. That’s the one thing that is interesting. The other thing is that there is a very high diversity between centers. So one center has a treatment A that they like better, treatment B is much more preferred. The time when we look at it is very different because some approvals came later. So bridging strategies also change over time. So it’s very complex and heterogeneous, and it’s very difficult to compare all of these different setups. So we had a couple of approaches and found very interesting things like the histology actually matters also for bridging efficacy and type of bridging. We have separated a large group of patients with like NOS, so the non-other specified DLBCL, and compared those with transformed follicular lymphoma, which are biologically different, are different in behavior when we treat them in CAR. And that’s the new finding then in that study is that they’re also very different when you think about what bridging you should use in those patients. So the long-term outcome is substantially different in those patients. Super intriguing. We’re currently digging deeper into those results and the manuscript is almost done. So we’re going to publish that hopefully very soon. So beyond what we actually had on the poster, there is much more to come.
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