Dr Winter on Real-World Outcomes With Liso-Cel in Richter Transformation

Allison Winter, MD, Department of Hematology and Medical Oncology, Cleveland Clinic, discusses findings from a retrospective analysis evaluating real-world outcomes with lisocabtagene maraleucel (liso-cel; Breyanzi) in patients with Richter transformation and the clinical implications of these results.

At the 2024 ASCO Annual Meeting, Winter presented findings from a multicenter, observational study investigating the real-world outcomes of patients with Richter transformation enrolled in the Center for International Blood and Marrow Transplant Research Cellular Therapy registry who received treatment with liso-cel from February 5, 2021, through August 4, 2023. At a median follow-up of 12.3 months (95% CI, 6.1-12.5), liso-cel elicited an overall response rate of 76% (n = 22; 95% CI, 56.5%-89.7%), including a complete response rate of 66% (n = 19; 95% CI, 45.7%-82.1%). The median time to first response was 1.1 months (range, 0-3.1).

Patients who responded to liso-cel had durable responses, Winter says. The median duration of response (DOR) was not reached (NR; 95% CI, 5.6 months-NR), and the 12-month DOR rate was 77% (95% CI, 49.5%-91.0%). Furthermore, the median overall survival (OS) was NR (95% CI, 10.4%-NR), and the 6- and 12-month OS rates were 79% (95% CI, 59.2%-90.1%) and 67% (95% CI, 43.6%-82.8%), respectively. The median progression-free survival (PFS) was NR (95% CI, 3.0 months-NR), and the 6- and 12-month PFS rates were 65% (95% CI, 44.8%-79.5%) and 54% (95% CI, 32.7%-71.6%), respectively.

Although many patients with Richter transformation are treated with chemoimmunotherapy, no standard of care exists for this population, Winter emphasizes. Furthermore, many patients do not respond to treatment or relapse soon after achieving a response, Winter notes. Therefore, the durable efficacy of liso-cel in this patient population was encouraging, especially since liso-cel is a commercially available product that requires a single infusion, Winter explains. Future research efforts may evaluate liso-cel–based combination regimens in this patient population, Winter concludes.