CAR-T Meeting 2024 | How has CAR-T changed survival outcomes in DLBCL so far?
Peter Vandenberghe, MD, UZ Leuven, Leuven, Belgium, summarizes a talk on how CAR T-cell therapy has changed survival outcomes in diffuse large B-cell lymphoma (DLBCL) so far. Initially investigated in the third line or later, CAR-T resulted in better outcomes than those of historical controls. In clinical trials in the second-line setting, event-free survival (EFS) was greater with CAR-T than with standard of care (SoC) salvage chemotherapy followed by autologous stem cell transplant (autoSCT). Prof. Vandenberghe emphasizes that it is vital to move to CAR-T immediately in the second-line setting, not once SoC treatment has failed. Additionally, Prof. Vandenberghe highlights that data from real-world practice demonstrates that in the real-world setting, it is possible to deliver outcomes comparable to those reported in clinical trials in patients with DLBCL. This interview took place at the EBMT-EHA 6th European CAR T-cell Meeting in Valencia, Spain.
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Transcript (edited for clarity)
Well, there are still very many challenges to be met. There are the challenges of:
What is the role of bridging therapy?
Do we need bridging for all patients? Initially, bridging was conceived as a way to hold the patient until infusion of CAR-T cells, and therefore, initially, the need for bridging therapy was perceived and recorded as a negative prognostic factor because these were the patients with really aggressive disease and high tumor burden...
Well, there are still very many challenges to be met. There are the challenges of:
What is the role of bridging therapy?
Do we need bridging for all patients? Initially, bridging was conceived as a way to hold the patient until infusion of CAR-T cells, and therefore, initially, the need for bridging therapy was perceived and recorded as a negative prognostic factor because these were the patients with really aggressive disease and high tumor burden.
Now we know that the application of bridging therapy can go further than just holding the patient. It goes further in that if bridging therapy works and bridging therapy induces a response, a partial response, or a complete response, the results of CAR T-cell therapy will be better.
So, an important challenge for the future will be how to integrate bridging therapy and the type of bridging therapy in a therapeutic strategy together with CAR T-cells, because the [less] disease left before we come in with the CAR T-cells, the higher the chance of a favorable outcome.
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Disclosures
Sponsorship or research funding: Janssen – Cilag, Pfizer;
Honoraria for advisory boards/meeting attendance support/consultancy/speaker fees: Bristol-Myers-Squibb, Gilead, Janssen-Cilag, Miltenyi Biotec, Novartis.
