Investigational Therapy in Mantle Cell Lymphoma: KTE-X19 CAR T-Cell Therapy - Episode 4

Implications of ZUMA-2 in R/R Mantle Cell Lymphoma

Michael Wang, MD: I really think this is a milestone, regarding progress in therapy for high-risk mantle cell lymphoma. It is going to change the way we treat high-risk mantle cell lymphoma. Please remember, because of the natural history of mantle cell lymphoma, almost all patients will eventually evolve into high risk. When they were high risk in the past, they are not curable. I cannot state that a CAR [chimeric antigen receptor] T-cell therapy is already proving curable. However, there’s a hope for long-term remission because we have observed long-term remissions. We saw this for about 39% of patients in an even more refractory disease called large cell lymphoma. In the ZUMA-1 clinical trial, after 3 or 4 years of follow-up, the curve still remains relatively flat, with over 30% of patients enjoying long-term remissions.

My feeling is that we probably will do a little better than we have in large cell lymphoma, but I cannot guarantee this. I can see that some of the patients already enjoy long-term remissions. Whether this is a curable modality or not totally depends on the test of time. We cannot claim cure, but we are cautiously optimistic, especially me. CAR T-cell therapy is changing the way we treat high-risk mantle cell lymphoma. Because all patients eventually become high risk, CAR T therapy will totally change the landscape of mantle cell lymphoma.

The most exciting part of the data is the overall response rate—87%—and the CR [complete response] rate—62%. After a median 1-year follow-up, overall survival has not been reached. The duration of remission has not been reached. The CRS [cytokine release syndrome] grade 3 or 4 toxicities are about 15%. Only 1 patient actually has a grade 5 CRS event. The majority of patients did very well. And the neurotoxicity, grade 3 or 4, is also around 15%. This is very comparable with other Kite Pharma ZUMA studies in large cell lymphoma and other lymphomas.

I really think these are very encouraging data. I’m looking forward to sharing the longer-term follow-up data with you during ASH [American Society of Hematology Annual Meeting] 2020.

Transcript edited for clarity.