Opinion

Video

Highlighting the Key Takeaways From ASH 2024

Panelists discuss how chimeric antigen receptor (CAR) T-cell therapy, bispecifics, and minimal residual disease (MRD) monitoring are reshaping lymphoma treatment strategies, with emerging data showing promising outcomes for various lymphoma subtypes and ongoing trials exploring optimal sequencing of these therapies.

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Summary of Recent Advancements in Lymphoma Treatment

This summary highlights Dr Andre Goy’s analysis of recent developments in lymphoma treatment approaches:

CAR T-Cell Therapy

  • New CAR T constructs are being explored to improve efficacy, including anti-CD22 approaches and “off-the-shelf” options.
  • MRD status post CAR T therapy strongly correlates with long-term outcomes.
  • CAR T therapy demonstrates curative potential in approximately 40% of large cell lymphoma patients and 35% or more in mantle cell lymphoma.

Bispecific Antibodies

  • Emerging as an important option for patients ineligible for CAR T or post CAR T relapse
  • Currently, CAR T remains preferable for heavily pretreated relapsed patients as bispecifics have not yet demonstrated curative potential.
  • Promising combinations with chemotherapy (eg, EPCO, miniCHOP) are being explored.
  • Particularly appealing for follicular lymphoma, both as monotherapy and in combination with other biologics

Novel Therapeutic Approaches

  • Tetrameric T-cell engagers with allogeneic natural killer cells showing promise in Hodgkin lymphoma, where CAR T has limited efficacy
  • Bruton tyrosine kinase inhibition: A UK study demonstrated superiority of ibrutinib plus rituximab over bendamustine plus rituximab.
  • The Triangle trial confirmed that when ibrutinib is combined with R-CHOP/R-DHAP, autologous transplant provides no additional benefit.

Treatment Sequencing and Personalization

  • Alliance data showed patients with mantle cell lymphoma who achieve MRD negativity may not benefit from autologous consolidation.
  • Increasing implementation of next-generation sequencing to guide therapy
  • Growing enthusiasm for AI applications to analyze unstructured data and identify optimal treatment approaches

Key focus on determining optimal treatment sequences and addressing equity in care access

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