Sairah Ahmed, MD, associate professor in the Department of Lymphoma/Myeloma and Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses the continued investigations of axicabtagene ciloleucel (axi-cel; Yescarta), a chimeric antigen receptor (CAR) T-cell therapy used in multiple types of lymphoma, including patients with mantle cell lymphoma, transformed follicular lymphoma, diffuse large B-cell lymphoma, primary mediastinal B-cell lymphoma, and high grade B-cell lymphoma.
Right now, there are many ongoing clinical trials looking at axi-cel in early-stage disease, and others investigating how to reduce toxicity while improving efficacy when using axi-cel in patients with lymphoma. Some of these trials include an investigation of axi-cel in patients with relapsed/refractory central nervous system lymphoma (NCT04608487) and as second-line therapy in patients with relapsed/refractory aggressive B lymphoma (NCT04531046). Ahmed thinks that this pinpoints a population that should most likely have a more aggressive treatment modality and potentially have some other treatment prior to or after CAR T-cell therapy to improve outcomes.
Although the research of CAR T-cell treatment is still in an earlier stage compared with some other cancer therapies, Ahmed says there needs to be a continued effort to evaluate which patients do well versus patients who do not do well and try to tailor treatment to those particular populations.