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EHA 2021 | PORTIA: tisa-cel in R/R DLBCL

Ulrich Jäger, MD, Medical University of Vienna, Vienna, Austria, gives an update on the PORTIA (NCT03630159) study of the safety and efficacy of tisagenlecleucel (tisa-cel) plus pembrolizumab in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). Primary endpoints of the study included incidence of dose-limiting toxicities (DLTs) and overall response rate. Secondary endpoints included duration of response, progression-free survival, overall survival and safety. Prof. Jäger reports that 3/4 patients responded in the Day -1 cohort, indicating that the addition of pembrolizumab may be active, however there was no indication of activity in the late post-CAR-T cohorts. Thus, Prof. Jäger concludes that the addition of pembrolizumab may not be suitable going forwards. This interview took place at the virtual European Hematology Association (EHA) Congress 2021.

Transcript (edited for clarity)

What we presented is an update of the PORTIA study. The PORTIA study is intended to add in a checkpoint inhibitor, pembrolizumab, to the currently approved indication for tisa-cel in diffuse large B-cell lymphoma. The idea is to enhance T-cell activity. What was done in the PORTIA study was that we added in the pembrolizumab in the first cohorts post-CAR T-cell treatment, and in the last cohort, pembrolizumab was administered one day before the CAR T-cells were given...

What we presented is an update of the PORTIA study. The PORTIA study is intended to add in a checkpoint inhibitor, pembrolizumab, to the currently approved indication for tisa-cel in diffuse large B-cell lymphoma. The idea is to enhance T-cell activity. What was done in the PORTIA study was that we added in the pembrolizumab in the first cohorts post-CAR T-cell treatment, and in the last cohort, pembrolizumab was administered one day before the CAR T-cells were given. This was an early-Phase study with four patients per category.

What we saw is that there were three out of four responses in the day -1 cohort showing some indication that there the addition of pembro may be active. There was no indication in the late post-CAR-T cohorts that this adds very much to the regular tisa-cel treatment. And in the end, it seems that also toxicity was not negligible in the day -1 cohort, so that it was decided that this is probably not the ideal way to go forward. There may be some patients who profit from the addition of checkpoint inhibitors, but like in other studies, it seems that there could be better ways of enhancing the tisa-cel.

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