Brian Till, MD, a physician at the Seattle Cancer Care Alliance, as well as an associate professor in the Division of Medical Oncology at the University of Washington School of Medicine and an associate professor of Clinical Research Division at the Fred Hutchinson Cancer Research Center, discusses the safety and efficacy of lisocabtagene maraleucel (liso-cel; Breyanzi) compared with other products under exploration in patients with mantle cell lymphoma (MCL).

Although the CAR T-cell product has only been examined in a small cohort of patients with MCL, with a short median follow-up in the phase 1 TRANSCEND-NHL-001 (NCT02631044), preliminary data have been promising, according to Till. Among the 32 patients treated with liso-cel, the overall response rate was 84%, and two-thirds of patients experienced a complete response, Till says.

These results were similar to those reported with brexucabtagene autoleucel (Tecartus) in patients with MCL, although the safety profiles of the 2 products differed; a lower incidence of severe cytokine release syndrome was reported with liso-cel, Till notes. The toxicities observed with liso-cel in patients with MCL were also comparable to those observed with the agent in large B-cell lymphoma, Till adds. The 2 therapies also differ in terms of outpatient vs inpatient administration, Till concludes.

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Brian Till, MD, discusses the safety and efficacy of lisocabtagene maraleucel compared with other products under exploration in patients with mantle cell lymphoma.
 

Dr. Till on Data With Liso-Cel Vs Other Products Under Examination in MCL

Brian Till, MD, physician, Seattle Cancer Care Alliance, associate professor, Division of Medical Oncology, University of Washington School of Medicine, associate professor, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses the utility of brexucabtagene autoleucel (Tecartus) in mantle cell lymphoma (MCL).

In July 2020, brexucabtagene autoleucel received FDA approval for the treatment of patients with relapsed/refractory MCL based on findings from the phase 2 ZUMA-2 trial, in which the CAR T-cell product elicited an 87% objective response rate in this patient population.

Updated follow-up data from the study, which were presented during the 47th Annual Meeting of the EBMT, demonstrated significant and durable responses, as well as a reduction in adverse effects, with brexucabtagene autoleucel in this patient population. 

Essentially, brexucabtagene autoleucel utilizes the same manufacturing construct as axicabtagene ciloleucel (axi-cel; Yescarta); however, brexucabtagene autoleucel has an added selection step to remove circulating leukemic disease that is often present in patients with MCL, concludes Till.

Brian Till, MD, discusses the utility of brexucabtagene autoleucel in mantle cell lymphoma.  



Dr. Till on the Utility of Brexucabtagene Autoleucel in MCL 

Brian Till, MD, physician, Seattle Cancer Care Alliance, associate professor, Division of Medical Oncology, University of Washington School of Medicine, associate professor, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses the potential durability of brexucabtagene autoleucel (Tecartus) in mantle cell lymphoma (MCL).

However, without long-term data, the durability of these responses remains largely unknown, says Till. Unlike large-cell lymphoma which can be cured, MCL and follicular lymphoma are considered incurable diseases with currently available therapies, Till explains. Currently, some patients appear to have late relapses after CAR T-cell therapy, but whether the survival curve will plateau or many patients will relapse can only be answered with additional follow-up, concludes Till.

Brian Till, MD, discusses the potential durability of brexucabtagene autoleucel in mantle cell lymphoma.  



Dr. Till on the Durability of Response With Brexucabtagene Autoleucel in MCL 

Brian Till, MD, physician, Seattle Cancer Care Alliance, associate professor, Division of Medical Oncology, University of Washington School of Medicine, associate professor, Clinical Research Division, Fred Hutchinson Cancer Research Center, discusses the potential to utilize CAR T-cell therapy earlier in the treatment of patients with mantle cell lymphoma (MCL).

For some, the toxicities associated with CAR T-cell therapy may limit its utility for patients with MCL, says Till. Moreover, those who are uncomfortable with CAR T-cell therapy may prefer to reserve the therapy for third- or later-line use, Till explains.

However, the emergence of improved management strategies for cytokine release syndrome and neurotoxicity, as well as less toxic CAR T-cell products, could offer a greater level of comfort to utilize CAR T-cell therapy in the second-line setting for patients with MCL, particularly if mature data suggest the responses are durable, Till concludes. 

Brian Till, MD, discusses the potential to utilize CAR T-cell therapy earlier in the treatment of patients with mantle cell lymphoma.  



Brian Till, MD

Articles

Dr. Till on Data With Liso-Cel Vs Other Products Under Examination in MCL

Dr. Till on the Utility of Brexucabtagene Autoleucel in MCL

Dr. Till on the Durability of Response With Brexucabtagene Autoleucel in MCL

Dr. Till on the Potential to Utilize CAR T-Cell Therapy Earlier in MCL