Jeremy Abramson, MD, discusses what the findings from the phase 3 TRANSFORM study of lisocabtagene maraleucel mean for patients with relapsed large B-cell lymphoma.
Jeremy Abramson, MD, director of the Center for lymphoma at Massachusetts General Cancer Center, associate professor of medicine at Harvard Medical School, discusses what the findings from the phase 3 TRANSFORM study (NCT03575351) of lisocabtagene maraleucel (Breyanzi; liso-cel) mean for patients with relapsed large B-cell lymphoma (LBCL).
Most patients with LBCL who relapse do so within 1 year of their initial treatment. According to Abramson, chimeric antigen receptor (CAR) T-cell therapy should be considered as a second-line treatment option for these patients.
0:09 | I think this is transformative therapy for the future of relapse large B-cell lymphoma. The majority of patients who relapse from large B-cell lymphoma relapse within 1 year of initial chemo immunotherapy, and that is the population that was included in our study. From my perspective, most patients who progress after frontline chemoimmunotherapy should receive a CAR T cell as their second-line treatment, rather than the historic standard of care of platinum-based chemotherapy followed by high-dose chemotherapy and autologous stem cell support.
0:45 | There are now 2 CAR T cells fully FDA approved in this space, axicabtagene ciloleucel [axi-cel; Yescarta], and lisocabtagene maraleucel, both of which showed exciting efficacy in this space. We presented and performed a match adjusted indirect comparison between the TRANSFORM and the ZUMA-7 [NCT03391466] trials, which matched for inclusion criteria and patient risk factors and found that the efficacy of liso-cel and axi-cel look quite comparable in the second-line setting for early relapsed or refractory large B-cell lymphoma, but that the safety profile significantly favors liso-cel with a dramatic reduction in incidence of cytokine release syndrome and neurologic toxicities with liso-cel compared with axi-cel. Ultimately, it is terrific to have not 1, but 2 highly effective CAR T-cell products available to maximize the likelihood of cure in second-line patients with large B-cell lymphomas.