Highlighting the Key Takeaways From ASH 2024

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Summary of Recent Advancements in Lymphoma Treatment

This summary highlights Dr Andre Goy’s analysis of recent developments in lymphoma treatment approaches:

CAR T-Cell Therapy

• New CAR T constructs are being explored to improve efficacy, including anti-CD22 approaches and “off-the-shelf” options.
• MRD status post CAR T therapy strongly correlates with long-term outcomes.
• CAR T therapy demonstrates curative potential in approximately 40% of large cell lymphoma patients and 35% or more in mantle cell lymphoma.

Bispecific Antibodies

• Emerging as an important option for patients ineligible for CAR T or post CAR T relapse
• Currently, CAR T remains preferable for heavily pretreated relapsed patients as bispecifics have not yet demonstrated curative potential.
• Promising combinations with chemotherapy (eg, EPCO, miniCHOP) are being explored.
• Particularly appealing for follicular lymphoma, both as monotherapy and in combination with other biologics

Novel Therapeutic Approaches

• Tetrameric T-cell engagers with allogeneic natural killer cells showing promise in Hodgkin lymphoma, where CAR T has limited efficacy
• Bruton tyrosine kinase inhibition: A UK study demonstrated superiority of ibrutinib plus rituximab over bendamustine plus rituximab.
• The Triangle trial confirmed that when ibrutinib is combined with R-CHOP/R-DHAP, autologous transplant provides no additional benefit.

Treatment Sequencing and Personalization

• Alliance data showed patients with mantle cell lymphoma who achieve MRD negativity may not benefit from autologous consolidation.
• Increasing implementation of next-generation sequencing to guide therapy
• Growing enthusiasm for AI applications to analyze unstructured data and identify optimal treatment approaches

Key focus on determining optimal treatment sequences and addressing equity in care access