The Lymphoma Channel on VJHemOnc is an independent medical education platform, supported with funding from AstraZeneca (Diamond), BMS (Gold), Johnson & Johnson (Gold), Takeda (Silver) and Galapagos (Bronze). Supporters have no influence on the production of content. The levels of sponsorship listed are reflective of the amount of funding given.
EHA 2024 | Advances and unmet needs in second-line treatment of DLBCL
Chris Fox, MBChB(Hons), MRCP, FRCPath, University of Nottingham, Nottingham, UK, discusses recent developments in second-line treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL). Recently, two CAR T-cell products, axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel), have been approved for patients who relapse within 12 months of first-line therapy. However, patients who relapse after 12 months, as well as those who are not eligible for autologous stem cell transplantation (SCT), remain reliant on conventional chemotherapy for second-line treatment. Dr Fox highlights that trials investigating combination therapies of bispecific antibodies and other agents may provide promising novel treatment approaches for these two groups of patients. This interview took place at the 29th Congress of the European Hematology Association (EHA) in Madrid, Spain.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript
So the treatment landscape in relapsed DLBCL, both in the second line and subsequent lines, is moving rapidly. So there’s a complex evolution of new therapies. So, it’s creating both benefit for our patients but also challenges in terms of deciding which treatment a patient should have.
In the second line setting, we have two CAR-T products approved from the ZUMA-7 and TRANSFORM study...
So the treatment landscape in relapsed DLBCL, both in the second line and subsequent lines, is moving rapidly. So there’s a complex evolution of new therapies. So, it’s creating both benefit for our patients but also challenges in terms of deciding which treatment a patient should have.
In the second line setting, we have two CAR-T products approved from the ZUMA-7 and TRANSFORM study. So we have axi-cel and liso-cell, both with very impressive survival outcomes in those patients who relapsed within 12 months of first-line therapy. But those studies enrolled patients who were fit for autologous transplant. So certainly, the reimbursement, at least in in the UK, is only relevant to patients who would be otherwise fit for autologous transplant. For those patients, axi-cel is available, and that’s our current approach.
However, that leaves two groups of patients who still have a problem in the second-line therapy. Patients who relapse later, or more importantly, patients who relapse early but are not considered to be autologous transplant candidates. And we are faced with this population of still using conventional chemotherapy in second line and looking ahead to third line options such as CAR-T or CD20 bispecific antibodies. And I think this group particularly is an area of unmet need, and I’m aware of trials coming into this space, including bispecifics in combination with other agents, and I think that’s really an area to watch.
Read more...
Disclosures
Consultancy/advisory boards: AbbVie, AstraZeneca, Atarabio, BMS, GenMab, Gilead/Kite, Incyte, Janssen, Lilly, Morphosys, Ono, Roche, SERB, SOBI, Takeda; Educational activities: AbbVie, Kite/Gilead, Incyte, Janssen, Roche, Takeda, SERB; Travel: Roche, Kite/Gilead; Research funding: BeiGene, AbbVie/GenMab.
