Relapsed/Refractory Diffuse Large B-Cell Lymphoma and Mantle Cell Lymphoma: Is It Time to Consider CAR-T for All?

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Andrew D. Zelenetz
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CAR T cells have demonstrated activity in relapsed/refractory non-Hodgkin lymphoma, including diffuse large B-cell lymphoma (DLBCL), indolent non-Hodgkin lymphoma, and mantle cell lymphoma. For patients with chemorefractory disease, CAR T cells can provide a durable complete response in a portion of patients, which represents a major advance in the field. For patients with chemosensitive disease, however, additional data are needed to determine whether CAR T cells are preferable to conventional approaches. Studies in DLBCL have shown that patients experiencing a PET-positive partial response after second-line chemotherapy have long-term outcomes after high-dose therapy and autologous stem cell rescue that are similar to CAR T-cell therapy, with decreased toxicity and cost. Alternative third-line options such as tafasitamab/lenalidomide and bispecific antibodies may also have a role for patients with chemorefractory disease.

Disclosures: Dr. Zelenetz has disclosed that he has received grant/research support from BeiGene, Gilead Sciences, Inc., MEI Pharma Inc., and Roche Laboratories, Inc.; has received consulting fees from Adaptive Biotechnologies Corporation, Amgen Inc, BeiGene, Celgene Corporation, Genentech, Inc./Roche Laboratories, Inc., Gilead Sciences, Inc., Janssen Pharmaceutica Products, LP, Novartis Pharmaceuticals Corporation, and Verastem Oncology; and is a Scientific Advisor for AbbVie, Inc, AstraZeneca Pharmaceuticals LP, Genentech, Inc., Gilead Sciences, Inc., MorphoSys AG, and Pharmacyclics.

Correspondence: Andrew D. Zelenetz, MD, PhD, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Email: zeleneta@mskcc.org
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  • 1.

    Locke FL, Ghobadi A, Jacobson CA, et al.. Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1-2 trial. Lancet Oncol 2019;20:3142.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Schuster SJ, Bishop MR, Tam CS, et al.. Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma. N Engl J Med 2019;380:4556.

  • 3.

    Abramson JS, Palomba ML, Gordon LI, et al.. Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study. Lancet 2020;396:839852.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Shah MA, Kennedy EB, Catenacci DV, et al.. Treatment of locally advanced esophageal carcinoma: ASCO guideline. J Clin Oncol 2020;38:26772694.

  • 5.

    Salles G, Duell J, González Barca E, et al.. Tafasitamab plus lenalidomide in relapsed or refractory diffuse large B-cell lymphoma (L-MIND): a multicentre, prospective, single-arm, phase 2 study. Lancet Oncol 2020;21:978988.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Morschhauser F, Flinn IW, Advani R, et al.. Polatuzumab vedotin or pinatuzumab vedotin plus rituximab in patients with relapsed or refractory non-Hodgkin lymphoma: final results from a phase 2 randomised study (ROMULUS). Lancet Haematol 2019;6:e254265.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Sehn LH, Herrera AF, Flowers CR, et al.. Polatuzumab vedotin in relapsed or refractory diffuse large B-cell lymphoma. J Clin Oncol 2020;38:155165.

  • 8.

    Wang M, Munoz J, Goy A, et al.. KTE-X19 CAR T-cell therapy in relapsed or refractory mantle-cell lymphoma. N Engl J Med 2020;382:13311342.

  • 9.

    Zelenetz AD, Gordon LI, Abramson JS, et al.. NCCN Clinical Practice Guidelines in Oncology: B-Cell Lymphomas. Version 4.2020. Accessed October 26, 2020. Available at NCCN.org

    • PubMed
    • Search Google Scholar
    • Export Citation
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