Carlos R. Bachier, MD, director, blood and marrow transplant research, Sarah Cannon Research Institute, discusses the investigational CAR T-cell therapy lisocabtagene maraleucel (liso-cel) in diffuse large B-cell lymphoma (DLBCL).

A biologics license application is currently under priority review by the FDA for liso-cel, a CD19-directed CAR T-cell product, says Bachier. 

the 2020 European Hematology Association Annual Congress

, findings from a study evaluating the safety and efficacy of liso-cel in patients who were monitored in the outpatient setting in the TRANSCEND NHL 001, TRANSCEND OUTREACH-007, and TRANSCEND-PILOT-017006 trials were presented.

Notably, CAR T-cell therapy is associated with a specific set of adverse effects (AEs), including cytokine release syndrome and neurologic toxicities, explains Bachier. However, liso-cel appears to have a relatively low incidence of late-onset AEs compared with other CAR T-cell products. 

As such, liso-cel may have utility as an outpatient therapy for patients with DLBCL pending further investigation, concludes Bachier.

Videos

Carlos R. Bachier, MD, discusses the investigational CAR T-cell therapy lisocabtagene maraleucel in diffuse large B-cell lymphoma.








Dr. Bachier on the Potential Benefits of Liso-Cel in DLBCL 

Carlos R. Bachier, MD, director, blood and marrow transplant research, Sarah Cannon Research Institute, discusses the toxicity profile of lisocabtagene maraleucel (liso-cel) that has been observed in 3 ongoing clinical trials in relapsed/refractory large B-cell non-Hodgkin lymphoma.

The adverse events (AEs) of liso-cel have been similar to that of other chimeric antigen receptor (CAR) T-cell products. With CAR T cells, there is potential for cytokine release syndrome (CRS), as well as neurological toxicities like confusion or seizures. These are known AEs of CAR T cells that are of concern with this therapy.

With liso-cel, the incidence rates, as well as severity, of neurological events and CRS appears lower compared with other CAR T-cell therapies, Bachier says.

Carlos R. Bachier, MD, discusses the toxicity profile of lisocabtagene maraleucel that has been observed in 3 ongoing clinical trials in relapsed/refractory large B-cell non-Hodgkin lymphoma.

Dr. Bachier on the Toxicity Profile of Liso-Cel

Carlos R. Bachier, MD, director, blood and marrow transplant research, Sarah Cannon Research Institute, discusses toxicities associated with stem cell transplant.

Stem cell transplant is one of the longest-established therapies in the treatment of hematologic malignancies. There are growing opportunities for patients with hematologic malignancies to benefit from stem cell transplantation. Although, there are important toxicities to consider.

Most common toxicities occur in the allogeneic transplant setting, Bachier says. While donors may be immunologically similar to the recipient, there are still differences between them. The cells that are infused into the recipient may attack the body, resulting in a complication called graft-versus-host disease (GVHD). This is one of the most serious complications that a patient can have after transplant, but new effective therapies to prevent and treat GVHD are being developed.

Carlos R. Bachier, MD, director, blood and marrow transplant research, Sarah Cannon Research Institute, discusses toxicities associated with stem cell transplant.
 

Dr. Bachier Discusses Toxicities With Stem Cell Transplant

Carlos R. Bachier, MD, program director of Sarah Cannon Center for Blood Cancer, Sarah Cannon Research Institute, discusses the relationship between chimeric antigen receptor (CAR) T-cell therapy and stem cell transplant.

The excitement with CAR T-cell therapy and T-cell receptor immune cells is very exciting, and has a relationship to the advancements being made with stem cell transplant, says Bachier. With the recent advances in cellular therapies, investigators are interested in finding whether there is a bridge between CAR T-cell therapy and stem cell transplant.

Bachier wonders if it is possible to get patients into deep remission with CAR T cells or immune effector cells so that stem cell transplant can be more effective. The concept is currently being developed and tested in acute lymphocytic leukemia, where there is still an incidence of relapse after CAR T-cell therapy.

Carlos R. Bachier, MD, program director of Sarah Cannon Center for Blood Cancer, Sarah Cannon Research Institute, discusses the relationship between chimeric antigen receptor (CAR) T-cell therapy and stem cell transplant.
 

Dr. Bachier Discusses CAR T-Cell Therapy and Stem Cell Transplant

Carlos R. Bachier, MD, director, blood and marrow transplant research, Sarah Cannon Research Institute, discusses the advancement of supportive care in hematologic malignancies.

Fifty years ago, bone marrow was the source of stem cells. Now, stem cells can be obtained from the peripheral blood. This has benefited patients in the autologous setting where their recovery of blood counts is much faster. The same is true in the allogeneic setting where donors are used.

One of the most important advances has been in supportive care, says Bachier. In transplants, particularly in the allogeneic transplant setting, patients can develop reactions such as graft-versus-host disease and infections. Over the past couple decades, therapies have been developed that have made transplants easier, lowered resulting toxicities, and improved overall survival.

Although advances have been made in supportive care, toxicity management still presents a challenge to physicians. Relapse remains the biggest challenge to physicians, especially in patients who have received an allogeneic transplant, Bachier explains. Ongoing studies are investigating methods of decreasing the rate of relapse after transplant.

Carlos R. Bachier, MD

Articles

Dr. Bachier on the Potential Benefits of Liso-Cel in DLBCL

Dr. Bachier on the Toxicity Profile of Liso-Cel

Dr. Bachier Discusses Toxicities With Stem Cell Transplant

Dr. Bachier Discusses CAR T-Cell Therapy and Stem Cell Transplant

Dr. Bachier on the Evolution of Stem Cell Transplants in Hematologic Malignancies