Large B-cell lymphoma is an extremely destructive, invasive subtype of non-Hodgkin lymphoma. Often, patients with this malignancy have undergone several treatments that have not worked. New therapeutic approaches are necessary for relapsed/refractory disease.
A breakthrough personalized treatment, CAR T-cell therapy may be an option for patients with relapsed/refractory large B-cell lymphoma. Patients undergo a process called leukapheresis, in which a patient's blood is collected and put through a machine that separates and accumulates T cells. After modifications allowing the T cells to recognize and attack malignancies, the patients receive them back intravenously.
A study conducted on the efficacy of CAR T-cell therapy, published in The Lancet, involved 108 patients receiving axicabtagene ciloleucel (Yescarta®, Kite Pharma, Inc.) for large B-cell lymphoma. These patients had previously undergone chemotherapy or a stem cell transplant that did not work. Of the 108 patients, 84 had an objective response, and 59 had a complete response. Remarkably, 39% of patients remained in remission for more than 2 years, and more than half of the patients treated remained alive.
According to Frederick Locke, MD, lead author of the article and Associate Member and Vice Chair of the Blood and Marrow Transplant and Cellular Immunotherapy Department, and co-leader of the Immunology Program at Moffitt Cancer Center, "This therapy has been a game-changer for patients with large B-cell lymphoma who have failed two or more lines of therapy. Our ZUMA-1 clinical trial data show durable response beyond 2 years for nearly 40% of patients who had almost no chance for complete responses with conventional chemotherapy. Importantly, ongoing remission 2 years after initial chemotherapy for large B-cell lymphoma is predictive of a cure, giving us hope that lymphoma will never return for many of the patients remaining in remission 2 years after axicabtagene ciloleucel."
For More Information
Locke FL, Ghobadi, A, Jacobson C, et al (2018). Long-term safety and activity of Axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicenter, phase 1-2 trial. Lancet Oncol. [Epub ahead of print] DOI:10.1016/S1470-2045(18)30864-7
Clinicaltrials.gov (2018). Safety and efficacy of KTE-C19 in adults with refractory aggressive non-hodgkin lymphoma (ZUMA-1). NLM identifier: NCT02348216.
Image courtesy of Ed Uthman