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Capitalizing on Promise of CAR T Cells in DLBCL

Caroline Seymour
Published: Thursday, Oct 04, 2018

Babis Andreadis, MD

Babis Andreadis, MD
Chimeric antigen receptor (CAR) T-cell therapy has activity in patients with relapsed diffuse large B-cell lymphoma (DLBCL), but there are a number of considerations to keep in mind before choosing to proceed with this treatment, explained Charalambos (Babis) Andreadis, MD, MSCE.

State of the Science Summit™ on Hematologic Malignancies, Andreadis, associate professor of clinical medicine, Department of Medicine, University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discussed the use of CAR T-cell therapy in patients with DLBCL and the associated toxicities with each product, as well as other promising therapies in the paradigm.

OncLive: How has CAR T-cell therapy impacted patients with DLBCL?

Andreadis: In the relapsed setting, DLBCL is still a disease in need of additional therapies. [Patients can do well with] transplant and may cure one-third of patients. There are a lot of patients who are ineligible for transplant or who don't respond well enough to chemotherapy to benefit from transplant. For those patients, we have CAR T-cell therapy, which can be active. My presentation focused on how we manage the toxicities of CAR T-cell therapies and how we triage patients for one or the other. Then, how we establish the production, efficacy, and toxicity of this treatment in the real-world setting.

Could you elaborate on the 2 FDA-approved CAR T-cell products?

There are 2 approved products now. One is tisagenlecleucel, which is a 4-IBB product. The other is axicabtagene-ciloleucel, which is a CD28 product. They have very similar activity, in my mind. The clinical trials that have been done show response rates in the 50% range and long-term responses in the 30% to 40% category. Those are the responses we're interested in because those are potentially the patients who can be cured.
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