David G. Maloney, MD, PhD, professor of medicine, Division of Oncology, University of Washington, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses updates with CAR T-cell therapy in non-Hodgkin lymphoma.
David G. Maloney, MD, PhD, professor of medicine, Division of Oncology, University of Washington, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses updates with chimeric antigen receptor (CAR) T-cell therapy in non-Hodgkin lymphoma (NHL).
There are now 3 CAR T-cell therapies of interest for patients with NHL, Maloney says. Axicabtagene ciloleucel (axi-cel; Yescarta), tisagenlecleucel (Kymriah), and JCAR017 have all shown promising data.
Updated findings of axi-cel show flat durable response rates, with 42% of people staying in remission at 15 to 18 months, says Maloney. Data presented at the 2018 ASCO Annual Meeting and the 2018 European Hematology Association Congress suggest that patients earlier on in the treatment course, or those with less tumor burden, may do better with axi-cel. Maloney says that escape mechanisms are also becoming better understood.
The JULIET trial, which was also presented at the 2018 European Hematology Association Congress, showed that at a median follow-up of 14.1 months, tisagenlecleucel achieved an objective response rate of 52% in adult patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). In May 2018, the FDA approved tisagenlecleucel for use in adult patients with relapsed/refractory large B-cell lymphoma. This indication included DLBCL, high-grade B-cell lymphoma and DLBCL arising from follicular lymphoma.
High response rates and high complete response rates have been seen with JCAR017, says Maloney. Interestingly, there is a lower risk of severe toxicities with that CAR T-cell therapy than with axi-cel or tisagenlecleucel, he notes.