Dr. Maziarz on Sustained Responses With Tisagenlecleucel in DLBCL

Richard T. Maziarz, MD
Published: Tuesday, Feb 19, 2019



Richard T. Maziarz, MD, professor of medicine at Oregon Health & Science University, Knight Cancer Institute, discusses sustained responses with tisagenlecleucel (Kymriah) in the treatment of patients with diffuse large B-cell lymphoma (DLBCL).

The community was probably surprised at first that the chimeric antigen receptor (CAR) T-cell product proved effective in humans—not just mouse models, says Maziarz. In the JULIET trial, which had updated data presented at the 2018 ASH Annual Meeting, investigators reported sustained responses with tisagenlecleucel in this patient population, beyond the short-term. This is especially important to note due to the skepticism that often comes with early data from clinical trials, where a drug might induce a short-term response in patients due to several factors, such as selection. Data showing long-term durable responses with the agent confirm its utility.

At a median follow-up of 19 months, over 40% of the patients were reported to be in sustained remission and 54% of the patients have a complete or partial remission. Maziarz notes that the patients in partial remission can still go into complete remission because the CAR T cells continue to work over time and remain in the body indefinitely. The natural history of DLBCL has changed, said Maziarz; patients who have historically had a very poor prognosis now have a chance of extending survival.
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Richard T. Maziarz, MD, professor of medicine at Oregon Health & Science University, Knight Cancer Institute, discusses sustained responses with tisagenlecleucel (Kymriah) in the treatment of patients with diffuse large B-cell lymphoma (DLBCL).

The community was probably surprised at first that the chimeric antigen receptor (CAR) T-cell product proved effective in humans—not just mouse models, says Maziarz. In the JULIET trial, which had updated data presented at the 2018 ASH Annual Meeting, investigators reported sustained responses with tisagenlecleucel in this patient population, beyond the short-term. This is especially important to note due to the skepticism that often comes with early data from clinical trials, where a drug might induce a short-term response in patients due to several factors, such as selection. Data showing long-term durable responses with the agent confirm its utility.

At a median follow-up of 19 months, over 40% of the patients were reported to be in sustained remission and 54% of the patients have a complete or partial remission. Maziarz notes that the patients in partial remission can still go into complete remission because the CAR T cells continue to work over time and remain in the body indefinitely. The natural history of DLBCL has changed, said Maziarz; patients who have historically had a very poor prognosis now have a chance of extending survival.

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