Caron Jacobson, MD

Caron Jacobson, MD, a senior physician and medical director of the Immune Effector Cell Therapy Program at Dana-Farber Cancer Institute, and an assistant professor of Medicine at Harvard Medical School, discusses the survival and response data for axicabtagene ciloleucel (axi-cel) from the phase 1/2 ZUMA-1 trial (NCT02348216).

Axi-cel, which is a CD19-directed chimeric antigen receptor (CAR) T-cell therapy, was looked at for the treatment of patients with relapsed/refractory aggressive B-cell non-Hodgkin lymphomas, including diffuse large B-cell lymphoma (DLBCL). These patients were all chemotherapy-refractory and had no other standard effective treatment options. Jacobson says in historical studies, these patients’ median overall survival (OS) would have been expected to be around the order of about 6 months. With a single infusion of axi-cel on this trial, there were responses in over 80% of patients and complete responses in over 50%.

With the 3-year data, and eventually the 4-year data, investigators will see that somewhere between 40% and 50% of patients maintain their response, which is very promising, Jacobson says. That could potentially mean patients could be cured with their single infusion of their CAR cells.

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Caron Jacobson, MD, discusses the survival and response data for axicabtagene ciloleucel from the phase 1/2 ZUMA-1 trial.

Axi-Cel Demonstrates Efficacy in Non-Hodgkin Lymphoma, Including DLBCL

Caron Jacobson, MD, medical director of the Immune Effector Cell Therapy Program and physician at Dana-Farber Cancer Institute, and assistant professor of medicine at Harvard Medical School, discusses the safety findings from the phase 2 ZUMA-5 tidal evaluating a CD19-directed chimeric antigen receptor (CAR) T-cell therapy, axicabtagene ciloleucel (axi-cel; Yescarta), in patients with follicular lymphoma (FL) and marginal zone lymphoma (MZL).

The safety profile was a little better in the FL cohort, so much so that it potentially raises the question of whether axi-cel could be administered in the outpatient setting, Jacobson says. About 23% of patients in the FL cohort had no cytokine release syndrome (CRS), and among those that did have CRS, the median time to onset was 4 days as opposed to 2 days in large cell lymphoma. Only 7% if patients in the FL cohort had high-grade CRS.

In terms of neurological toxicity in the FL cohort, 15% had high-grade events, which remains in line with what is expected with axi-cel in large cell lymphoma, Jacobson says.

The MZL cohort had a slightly higher incidence of CRS and higher-grade neurological toxicity that was more aligned with data for diffuse large B-cell lymphoma, according to Jacobson. The median time to onset of CRS in this cohort was about 4 days as well, so it was the same degree of toxicity with the FL cohort but later than we are used to seeing in large cell lymphoma.

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Caron Jacobson, MD, discusses the safety findings from the phase 2 ZUMA-5 tidal evaluating axicabtagene ciloleucel in patients with follicular lymphoma and marginal zone lymphoma.

Caron Jacobson, MD | Authors

Articles

Axi-Cel Demonstrates Efficacy in Non-Hodgkin Lymphoma, Including DLBCL

Toxicity Profile of CAR T-Cell Therapy Appears Safe in Follicular and Marginal Zone Lymphomas