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Blood Cancer

Highlights from Day 3: pushing the boundaries of CAR-T therapy in multiple myeloma & lymphoma [Video]

In this discussion, leading experts Yi Lin, MD, PhD, Mayo Clinic, Rochester, MN, Krina Patel, MD, MSc, The University of Texas MD Anderson Cancer Center, Houston, TX, Suzanne Trudel, MD, MSc, Princess Margaret Cancer Centre, Toronto, Canada, and Frederick Locke, MD, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, share their highlights from the lymphoma and myeloma sessions that took place at the 4th International Workshop on CAR-T (iwCAR-T) 2022 held in Tampa, FL. The experts share their excitement for the practice-changing trial data demonstrating the benefit of CAR-T therapy in second line in large B-cell lymphoma (LBCL), as well as for the possibility of approaching a cure in follicular lymphoma (FL). They then move on to discuss strategies to overcome the challenges associated with CAR-T therapy in multiple myeloma, including allogeneic CAR-Ts, where they discuss emerging data on various allogeneic CAR-T products. The experts then comment on the potential of bispecific antibodies in myeloma and how patients might be selected to receive BCMA-directed CAR-T therapy or bispecific antibodies in the future. Finally, the experts discuss real-world data on CAR-T therapy for mantle cell lymphoma (MCL) and multiple myeloma.

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Blood Cancer

Advances in CAR-T therapy for lymphoma [Video]

In this discussion chaired by David Maloney, MD, PhD, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, Caron Jacobson, MD, MMSc, Dana Farber Cancer Institute, Boston, MA, and Loretta Nastoupil, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, talk on moving CAR-T therapy earlier in the treatment algorithm of high-risk large B-cell lymphoma (LCBL), and share their thoughts on the follow-up data of studies evaluating CAR-T therapy in mantle cell lymphoma (MCL) and follicular lymphoma (FL). Based on the results of the TRANSFORM (NCT03575351) and ZUMA-7 (NCT03391466) studies, the experts debate which LBCL patients should be selected to receive CAR-T therapy or autologous transplantation in the second-line setting. Additionally, Dr Maloney, Dr Jacobson and Dr Nastoupil comment on encouraging data from the ZUMA-12 study (NCT03761056) which provides strong evidence for further testing CAR-T therapy in the frontline setting. Moving forward, the experts talk on the efficacy of brexucabtagene autoleucel (brexu-cel) in MCL, and also talk on the updated data from the ZUMA-5 study (NCT03105336) in patients with FL, discussing the possibility of administering this therapy in the outpatient setting and of approaching a cure. This interview took place at the 4th International Workshop on CAR-T (iwCAR-T) 2022 held in Tampa, FL.

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Blood Cancer

Latest updates in CAR-T therapy for follicular lymphoma [Video]

Peter Riedell, MD, University of Chicago Medicine, Chicago, IL, provides an overview of recent advances in CAR-T therapy for follicular lymphoma (FL). Axicabtagene ciloleucel (axi-cel) was the first CAR-T therapy to be approved in FL. The promising results of the ZUMA-5 (NCT03105336) and ELARA (NCT03568461) studies are expected to lead to the approval of tisagenlecleucel (tisa-cel) in relapsed/refractory (R/R) FL. Further longitudinal data is required to better understand the impact of CAR-T therapy in patients with FL, as well as to determine which patients are most likely to benefit from this immunotherapy. This interview took place at the Transplantation & Cellular Therapy (TCT) Meetings of ASTCT™ and CIBMTR® 2022 in Salt Lake City, Utah.

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Blood Cancer

The evolving treatment landscape of R/R LBCL [Video]

Manali Kamdar, MD, University of Colorado Cancer Center, Aurora, CO, comments on current and emerging immunotherapies for relapsed/refractory (R/R) large B-cell lymphoma (LBCL). In recent years, a large number of agents have been approved, namely tafasitamab-lenalidomide, polatuzumab vedotin with rituximab and bendamustine, loncastuximab tesirine, and CAR-T therapy in both second and third-line therapy. In addition, multiple promising agents are currently under investigation. These include bispecific antibodies such as mosunetuzumab and glofitamab, and studies have reported high efficacy with a highly manageable toxicity profile in heavily pre-treated patients. In parallel, existing CAR-T constructs are being improved and new constructs targeting new antigens are being evaluated. There is also progress in the field of R/R Hodgkin lymphoma, where CD30-directed CAR-Ts co-expressing CCR4 have shown encouraging results. This interview took place at the Transplantation & Cellular Therapy (TCT) Meetings of ASTCT™ and CIBMTR® 2022 in Salt Lake City, Utah.

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Blood Cancer

Exciting CAR-T data in multiple myeloma and follicular lymphoma: CARTITUDE-2, ELARA & ZUMA-5 [Video]

Dholaria Bhagirathbhai, MBBS, Vanderbilt University Medical Center, Nashville, TN, shares his thoughts on the most exciting data in CAR-T therapy that will be released at this year’s Tandem Meetings, including results from the CARTITUDE-2 (NCT04133636), ELARA (NCT03568461), and ZUMA-5 (NCT03105336) studies. This interview took place at the Transplantation & Cellular Therapy (TCT) Meetings of ASTCT™ and CIBMTR® 2022 in Salt Lake City, Utah.

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Blood Cancer

Targeted therapy for the treatment of follicular lymphoma [Video]

Loretta Nastoupil, MD, University of Texas MD Anderson Center, Houston, TX, gives an overview on when to use targeted therapy in the treatment of follicular lymphoma (FL), highlighting several novel agents and trials investigating this. Dr Nastoupil first mentions some findings from the AUGMENT study (NCT01938001), which investigated the use of lenalidomide plus rituximab in relapsed/refractory (R/R) indolent lymphoma. Dr Nastoupil then draws focus on novel therapeutic agents such as tazemetostat, parsaclisib, CAR-T therapy, and bispecific antibodies, and the role that these will play in the future of targeted therapy for FL. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA, 2021.

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Blood Cancer

Long-term follow-up results of ZUMA-5: axi-cel in patients with R/R indolent NHL [Video]

Sattva Neelapu, MD, University of Texas MD Anderson Cancer Center, Houston, TX, outlines the design and updated findings of the Phase II ZUMA-5 study evaluating axicabtagene ciloleucel (axi-cel) in patients with relapsed/refractory (R/R) indolent non-Hodgkin lymphoma (NHL) (NCT03105336). This study included patients with follicular lymphoma (FL) and marginal zone lymphoma (MZL) who had received at least two lines of prior therapy. The study reported overall response rates (ORR) of 94% and 83% and complete response (CR) rates of 79% and 63% in patients with FL and MZL respectively. In addition, 57% and 50% of patients with FL and MZL respectively were still in remission at data cutoff. Axi-cel demonstrated a manageable safety profile, with mostly grade 1 or 2 cytokine release syndrome (CRS) and neurological events. In addition, patients with follicular lymphoma experienced less grade 3 or higher neurological adverse events than patients with MZL. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.

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Blood Cancer

Atezolizumab with R-GEMOX in patients with transformed DLBCL [Video]

Alex Herrera, MD, City of Hope, Duarte, CA, shares an update on the study evaluating the addition of the PD-L1 inhibitor, atezolizumab, to immunogenic chemoimmunotherapy, rituximab with gemcitabine and oxaliplatin (R-GEMOX) in patients with relapsed/refractory (R/R) transformed diffuse large b-cell lymphoma (DLBCL) or Richter transformation (RT) from chronic lymphocytic leukemia (CLL). While patients with RT did not show outstanding responses, the patients with transformed follicular lymphoma and transformed marginal zone lymphoma presented good response rates. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.

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Blood Cancer

Tazemetostat and rituximab in r/r follicular lymphoma [Video]

Krish Patel, MD, Swedish Cancer Institute, Seattle, WA, comments on preliminary findings from a Phase II single-arm, open-label trial (NCT04762160) of tazemetostat, an enhancer of zeste homolog 2 (EZH2) inhibitor, with rituximab in patients with relapsed/refractory follicular lymphoma (FL). Five patients have been enrolled so far and tazemetostat with rituximab have shown initial promise in patients, with further data yet to be published. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.

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Blood Cancer

RELEVANCE: Rituximab and lenalidomide in FL [Video]

Nathan Fowler, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, shares an overview of the phase III RELEVANCE trial (NCT01650701) of rituximab and lenalidomide (R2) versus rituximab-chemotherapy followed by rituximab maintenance in patients with high tumor burden, untreated follicular lymphoma (FL). Six years after initial treatment, both treatment arms demonstrated similar efficacy and survival, highlighting R2 as a viable chemotherapy-free treatment option. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.

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Blood Cancer

ELARA: Tisa-cel in follicular lymphoma [Video]

Nathan Fowler, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, provides an update on the Phase II ELARA trial (NCT03568461), which assessed tisagenlecleucel (tisa-cel), a CD19-directed chimeric antigen receptor (CAR) T-cell therapy, in patients with follicular lymphoma (FL). Tisa-cel improved progression-free survival across different subtypes of FL, including patients who progressed within 2 years (POD24). Patients who received tisa-cel in an outpatient setting also were less likely to require hospitalization, highlighting the ability for CAR T-cell therapies to be administered in an outpatient setting for patients with a low-risk disease. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.

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Blood Cancer

The role of MRD in the management of indolent NHL [Video]

Robin Foà, MD, Sapienza University of Rome, Rome, Italy, gives an overview of his talk on the clinical value of measurable residual disease (MRD) in indolent non-Hodgkin lymphoma (NHL), with a focus on follicular lymphoma (FL). Prof. Foà discusses the role of MRD monitoring in stratifying patients into different risk categories at diagnosis, as well as in refining the degree of clinical response to treatment and in predicting progression-free survival (PFS). In addition, the value of MRD in molecular testing and in helping treatment choice will also be examined. Despite its wide use in clinical trials and a large body of evidence demonstrating the benefits of MRD monitoring, it has not yet been implemented in clinical practice. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.