Miguel-Angel Perales, MD, discusses replacing autologous stem cell transplant with CAR T-cell therapy in diffuse large B-cell lymphoma.
Miguel-Angel Perales, MD, deputy chief, Adult Bone Marrow Transplant Service, director, Adult Bone Marrow Transplantation Fellowship Program, Memorial Sloan Kettering Cancer Center, discusses replacing autologous stem cell transplant (ASCT) with CAR T-cell therapy in diffuse large B-cell lymphoma (DLBCL).
CAR T-cell therapy is approved for patients who have failed on ASCT. Given its efficacy in this setting, investigators have launched 3 large, phase III trials to compare its efficacy with ASCT, says Perales.
In the phase II ZUMA-7 trial, patients in first relapse will be randomized to axicabtagene ciloleucel (axi-cel; Yescarta) or second-line salvage therapy, followed by high-dose therapy and ASCT. The trial recently completed accrual, states Perales.
In two similarly designed studies, patients will receive salvage chemotherapy followed by either CAR T cell-therapy or ASCT, explains Perales. Pending the results of the trials, a cost-effectiveness analysis will need to be done as CAR T-cell therapy is relatively expensive.