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Opinion|Videos|February 10, 2025

Real World Perspectives: Considerations and Challenges for CAR T-cell Therapy in Relapsed/Refractory DLBCL

Author(s)David Miklos, MD, Haifaa Abdulhaq, MD, Frederick Locke, MD

An overview of challenges with CAR T-cell therapy, including combating T-cell exhaustion, the pros and cons of outpatient administration, logistical barriers, and the role of polatuzumab in bridging therapy, along with a discussion of non-cellular second-line options such as pola+BR and findings from L-MIND compared to real-world data

Episodes in this series

EP. 1 Emerging Updates in Front-line Treatment Approach of DLBCL

EP. 1 Emerging Updates in Front-line Treatment Approach of DLBCL

EP. 2 Insights from POLARIX: How do Novel Perspectives Influence Treatment Outcomes in DLBCL?

EP. 2 Insights from POLARIX: How do Novel Perspectives Influence Treatment Outcomes in DLBCL?

EP. 3 The Evolving First-line Treatment Approach for DLBCL

EP. 3 The Evolving First-line Treatment Approach for DLBCL

EP. 4 Future Considerations for Front-line Treatment of DLBCL

EP. 4 Future Considerations for Front-line Treatment of DLBCL

EP. 5 Role of Testing in Treatment Decisions - ClonoSeq, PhaseSeq, MRD+Disease

EP. 5 Role of Testing in Treatment Decisions - ClonoSeq, PhaseSeq, MRD+Disease

$EP. 6 Second-line Treatment Landscape in Relapsed/Refractory DLBCL$

EP. 6 Second-line Treatment Landscape in Relapsed/Refractory DLBCL

$EP. 7 The Emerging Role of Second-line CAR T-cell Therapy in Relapsed/Refractory DLBCL$

EP. 7 The Emerging Role of Second-line CAR T-cell Therapy in Relapsed/Refractory DLBCL

$EP. 8 Safety Considerations for Second-line CAR T-cell Therapy in Relapsed/Refractory DLBCL$

EP. 8 Safety Considerations for Second-line CAR T-cell Therapy in Relapsed/Refractory DLBCL

$EP. 9 Real World Perspectives: Outcomes for CAR T-cell Therapy in Relapsed/Refractory DLBCL$

EP. 9 Real World Perspectives: Outcomes for CAR T-cell Therapy in Relapsed/Refractory DLBCL

$EP. 10 Real World Perspectives: Considerations and Challenges for CAR T-cell Therapy in Relapsed/Refractory DLBCL$

EP. 10 Real World Perspectives: Considerations and Challenges for CAR T-cell Therapy in Relapsed/Refractory DLBCL

$EP. 11 Additional Perspectives Beyond CAR T-cell Regimens in Relapsed/Refractory DLBCL.: Bispecifics$

EP. 11 Additional Perspectives Beyond CAR T-cell Regimens in Relapsed/Refractory DLBCL.: Bispecifics

$EP. 12 Academic Insights for the Treatment of Later Relapsed/Refractory DLBCL$

EP. 12 Academic Insights for the Treatment of Later Relapsed/Refractory DLBCL

$EP. 13 Bispecific Antibodies in the Relapsed/Refractory DLBCL Treatment Landscape$

EP. 13 Bispecific Antibodies in the Relapsed/Refractory DLBCL Treatment Landscape

$EP. 14 Future Perspectives for the Treatment of Relapsed/Refractory DLBCL$

EP. 14 Future Perspectives for the Treatment of Relapsed/Refractory DLBCL

Video content above is prompted by the following:

Please give an overview of outstanding challenges for both patients and practitioners with the CAR T-cell regimen.

How can T-cell exhaustion be combated?
What are the advantages and limitations of outpatient administration. In your opinion, how can any issues with outpatient administration be addressed?
What other logistical barriers are present with CAR T-cell regimens, and how does bridging therapy help address these concerns?
What are your thoughts on the use of polatuzumab (pola) in bridging therapy (Liebers et al. Blood Adv 2021; Kim et al. ASH 2024)?

For a patient who does not receive 2L cellular therapy whether based on logistical or clinical reasons, what are the available treatment options?

Please discuss key takeaways from pola+ BR (Sehn et al. Blood Adv. 2022). What can we learn from these updates?
What are the major findings from L-MIND, and how does that compare to real world data (Duell J et al. Haematologica 2021; Zinzani et al. Clin Cancer Res 2021)?
In your practice, how would you choose between the available options?

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