This is a synopsis of a Peer Exchange series featuring James K. McCloskey, MD, and Lori A. Leslie, MD, of John Theurer Cancer Center, Hackensack University Medical Center.

Dr. Lori Leslie, Associate Professor of Medicine and Director of Indolent Lymphoma and CLL Research Programs at the John Theurer Cancer Center, discusses a subgroup analysis from the ZUMA-7 trial presented at the 2022 ASH Annual Meeting. ZUMA-7 previously demonstrated superior event-free survival, progression-free survival, and overall survival with axicabtagene ciloleucel (axi-cel) CAR T-cell therapy versus standard salvage chemotherapy/autologous stem cell transplant for relapsed/refractory diffuse large B-cell lymphoma patients within 12 months of frontline treatment.

This new analysis specifically evaluated patients over 65 years old, comprising around 70 patients including some over 70. It revealed consistent overall survival benefits from axi-cel in this older population, with hazard ratios of 0.69 for those 65-70 years old and an even more impressive 0.33 for those over 70 years old. Thus, advanced age alone should not preclude CAR T-cell therapy consideration if patients otherwise meet eligibility criteria. Dr. Leslie explains extensive real-world experience demonstrates feasibility and efficacy of CAR T-cell therapy for lymphoma patients even over 80 years old, with manageable toxicity. While the ZUMA-7 population was younger and fitter than typical real-world patients, this study clearly demonstrates elderly patients derive significant overall survival gains from axi-cel versus standard therapies.

Given older patients are often offered fewer options, this provides vital evidence to support aggressively advocating CAR T-cell therapy for eligible relapsed/refractory diffuse large B-cell lymphoma patients regardless of age. Dr. Leslie suggests this data should prompt strong consideration of axi-cel as early as second-line for older DLBCL patients given its survival benefits over even autologous stem cell transplant.

*Video synopsis is AI-generated and reviewed by OncLive editorial staff.