EBMT 2023 | Current and emerging indications for CAR-T therapy in LBCL

The first indications for autologous anti-CD19 CAR T-cell constructs in large B-cell lymphoma were in those patients that failed at least two prior lines of therapy. So basically, in third line or plus. The use of autologous CAR T-cells in this specific setting demonstrated in retrospective analysis that they were able to improve the long-term outcome of patients with relapsed/refractory diffuse large B-cell lymphoma, significantly with respect to more standard treatment strategies. Nowadays, we have data coming from two prospective randomized clinical trials indicating that two different constructs, axi-cel and liso-cel give significant, better long-term outcomes than the standard of care which is salvage chemotherapy plus autologous stem cell transplantation in patients with primary refractory disease or in patients with earlier relapse. So, in this setting, we have been able to move a little bit forward the use of CAR T in this specific disease. And of course, CAR T are going to be tested in the near future, in the setting of prospective clinical trials in patients first-line with high-risk disease. And they have also been tested in patients that are not candidates for an autologous stem cell transplantation.