How CAR T Cells Can Change the Treatment Landscape for Non-Hodgkin Lymphoma

David Maloney, MD, PhD, medical director, Cellular Immunotherapy Integrated Research Center (IIRC), Fred Hutchinson Cancer Research Center, discusses the results of the ZUMA trial and how chimeric antigen receptor (CAR) T-cell therapy is changing the treatment landscape for non-Hodgkin lymphoma.

The ZUMA-1 trial, which is studying the safety and efficacy of the use of axicabtagene ciloleucel (axi-cel; Yescarta) in adult patients with refractory aggressive non-Hodgkin lymphoma, showed durable responses and a median overall survival of over 2 years, according to the long-term follow-up data. The drug also showed a tolerable safety profile. Maloney says these data suggest that about 40% of patients with diffuse large B-cell lymphoma (DLBCL) have long-term remission and may be cured with axi-cel.

Although the data are promising, oncologists still have to focus on the 60% of patients who don’t have this response. Minimizing cytokine release syndrome and neurotoxicity is one way to help more patients in the future, he suggests. Oncologists can also look to other agents, like lisocabtagene maraleucel (JCAR017), which has shown less severe toxicity. As other CAR T-cell therapies emerge, physicians will have more options and can decide what is best for each patient based on safety and efficacy, says Maloney.