Jeremy Abramson, MD, director of the Jon and Jo Ann Hagler Center for Lymphoma at the Massachusetts General Hospital Cancer Center, shared his take on the potential benefits of chimeric antigen receptor (CAR) T-cell therapy in earlier lines of treatment.
Earlier administration of chimeric antigen receptor (CAR) T-cell therapy may be ideal in large B-cell lymphoma, said Jeremy Abramson, MD, associate professor of medicine at Harvard Medical School and director of the Jon and Jo Ann Hagler Center for Lymphoma at the Massachusetts General Hospital Cancer Center.
How do clinicians decide whether to use CAR T-cell therapy early or after another therapy?
Well, I think the ultimate [question] is where does it work the best? And CAR T-cell therapy seems to work best the sooner you give it. We initially had CAR T cells approved in the third line or later setting for large B-cell lymphoma, but now between the ZUMA-7 and the TRANSFORM trials, we see very clearly that earlier CAR T cells are better than giving platinum-based chemotherapy and high-dose chemotherapy and saving that in reserve. We saw that reflected in the in the crossover population on the TRANSFORM trial, where patients were randomized to standard of care and then crossed over to receive liso-cel when standard of care failed, had lower rates of complete response, progression-free, and event-free survival than patients who is least three received liso-cel in a second line setting. We saw data presented yesterday at the ASH Annual Meeting from the ZUMA-7 trial that looked at patients on the standard-of-care arm of that trial, who subsequently received a commercial CAR T-cell [therapy] after failure of standard of care. And they saw identical findings to what we saw, which is lower rates of complete response and progression-free survival for patients who received axi-cel as a third-line treatment rather than patients randomized to receive it in the second-line setting.