Dr. Megan Melody introduces the program and welcomes Dr. Miguel Perales and Dr. Nirav Shah before framing the discussion around the evolving role of real-world evidence in large B-cell lymphoma (LBCL).
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Real-World Evidence: Optimizing Patient Selection for CAR T-Cell Therapy in Large B-Cell Lymphoma
This OncLive® Insights program explores how real-world evidence (RWE) is shaping the use of CAR T-cell therapy in relapsed or refractory large B-cell lymphoma (LBCL). Dr. Megan Melody, Dr. Miguel-Angel Perales, and Dr. Nirav Shah discuss the evolving role of the three FDA-approved CD19-directed CAR T-cell therapies, including their positioning across the second- and later-line settings and how RWE complements pivotal clinical trial data. The panel examines how clinicians can use real-world data to assess CAR T-cell candidacy beyond traditional trial eligibility criteria, considering age, comorbidities, performance status, disease burden, geriatric vulnerabilities, and practical support systems. The discussion also addresses timely referral, bridging therapy, site-of-care considerations, outpatient delivery, and post-infusion logistics. Throughout the program, the experts highlight how RWE can support individualized treatment decisions and help clinicians identify the right patient for CAR T-cell therapy at the right time.
Real-World Evidence: Optimizing Patient Selection for CAR T-Cell Therapy in Large B-Cell Lymphoma
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Dr. Shah discusses why real-world evidence (RWE) is particularly important in large B-cell lymphoma, where the three approved CAR T-cell products were evaluated in separate pivotal trials rather than direct head-to-head comparisons.
Dr. Perales discusses how clinicians should interpret real-world evidence alongside pivotal clinical trial data in large B-cell lymphoma.
Dr. Melody introduces a clinical scenario involving Mr. R, a 71-year-old patient with relapsed large B-cell lymphoma, well-controlled hypertension, mild stable chronic kidney disease, preserved independence, and strong caregiver support.
Dr. Melody and Dr. Perales discuss how comorbidities should be considered when evaluating patients with large B-cell lymphoma for CAR T-cell therapy.
Dr. Shah describes the clinical and functional assessments he uses when evaluating patients with large B-cell lymphoma for CAR T-cell therapy.
Dr. Melody revisits Mr. R's treatment course after his local oncologist refers him to a regional cell therapy center, highlighting the importance of coordinating treatment for a patient with aggressive, symptomatic large B-cell lymphoma who lives 90 minutes away.
Dr. Shah discusses how bridging and holding therapy can be coordinated for patients with symptomatic or rapidly progressing large B-cell lymphoma who face logistical delays before CAR T-cell infusion.
As the program concludes, Dr. Melody asks Dr. Perales and Dr. Shah to share key takeaways for community oncologists and discuss emerging real-world data and innovations that could improve access to CAR T-cell therapy for patients with large B-cell lymphoma.
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