CAR-T Therapy Response Independent of Disease Factors in NHL

07/10/17

A recent clinical trial of a chimeric antigen receptor (CAR) T-cell therapy showed a significantly high response rate in treatment-resistant and relapsed aggressive non-Hodgkin lymphoma (NHL) independent of disease type, stage, or characteristics.

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Current outcomes for patients with refractory aggressive NHL are poor and novel therapies are needed. An interim analysis of the first multicenter trial (ZUMA-1) involving the CAR T-cell therapy axicabtagene ciloleucal (KTE-C19) for treating refractory aggressive NHL showed an objective response rate (ORR) of 79%.

Primary analysis and results of ZUMA-1 were presented at the 22nd Congress of the European Hematology Association (June 22-25, 2017; Madrid, Spain).

Researchers led by Yi Lin, MD, PhD, Mayo Clinic (Rochester, MN), recruited 101 patients with diffuse large B-cell lymphoma, primary mediastinal B-cell lymphoma, or transformed follicular lymphoma who were previously treated with KTE-C19. Eighty-five percent of these patients exhibited stage III/IV disease, and approximately 50% had an International Prognostic Index of 4 or 4, indicating a poor prognosis.

Results of the trial showed that 82% of patients responded to KTE-C19 therapy. Researchers reported that the ORR remained constant when controlling for disease subtypes, refractory status, lymphoma status, or International Prognostic Index score.

Patients were followed for a median of 8.7 months at the time of analysis. Median duration of response was 8.2 months in the entire group, but had not been reached among patients who demonstrated a complete response (39%). Median overall survival had not been reached; at six months, 80% of patients were still alive.

Common adverse events associated with KTE-C19 include lowered blood cell counts, severe cytokine release syndrome, and neurological events. Nonetheless, researchers acknowledged that all of the adverse events observed in the patient population were resolved, with the exception of one mild memory impairment.

Researchers concluded that the safety profile the CAR T-cell therapy is manageable in patients with treatment-resistant or relapsed aggressive NHL and should be considered for those patients who lack other treatment options for their disease.—Zachary Bessette