touchEXPERT BRIEFING CAR T-cell treatment pathway: From patient identification to long-term management
Watch leading experts discuss CAR T-cell treatment pathways in non-Hodgkin lymphoma and multiple myeloma, from patient identification to long-term management.
Prof. Ulrich Jäger outlines the potential benefit of CAR T-cell therapy in appropriate patients with non-Hodgkin lymphoma, including how to select suitable patients, making referrals and the benefits of early referral.1/3 Next Interview
Dr Maria-Victoria Mateos outlines the potential benefit of CAR T-cell therapy in appropriate patients with multiple myeloma, including data from clinical trials, key factors in selecting patients, and the benefits of early referral.2/3 Next Interview
Dr Robin Sanderson discusses the journey of a patient receiving CAR T-cell therapy including the key steps from collection to infusion, where these stages are managed, and how to manage toxicities.3/3 Leave Feedback
Learning Objectives & Overview
CAR T-cell therapy has led to improvements in disease outcomes for patients with non-Hodgkin lymphoma and multiple myeloma.1–14
In this activity, leading experts outline the factors and eligibility criteria influencing treatment decisions, the importance of early referral and referral challenges, and the key steps in delivering CAR T-cell therapy, including the management of toxicities.
After watching this activity, participants should be better able to:
- Outline the potential benefit of CAR T-cell therapy in appropriate patients and how suitable patients can be identified and referred.
- Describe the patient journey for CAR T-cell therapy.
- Discuss how patients can be monitored and managed once they have been discharged from hospital.
- 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(1):31-42.
- Schuster SJ, Tam CT, Borchmann P, et al. Long-term clinical outcomes of tisagenlecleucel in patients with relapsed or refractory aggressive B-cell lymphomas (JULIET): a multicentre, open-label, single-arm, phase 2 study. Lancet Oncol. 2021;22(10):1403-1415.
- Abramson JS, Palomba ML, Gordon LI, et al, Two-Year Follow-up of Transcend NHL 001, a Multicenter Phase 1 Studyof Lisocabtagene Maraleucel (liso-cel) in Relapsed or Refractory (R/R) Large B-Cell Lymphomas (LBCL). Blood. 2021;138(S1):2840-2840.
- Riedell PA, Walling C, Nastoupil LJ, et al. A Multicenter Retrospective Analysis of Clinical Outcomes, Toxicities, and Patterns of Use in Institutions Utilizing Commercial Axicabtagene Ciloleucel and Tisagenlecleucel for Relapsed/Refractory Aggressive B-Cell Lymphomas. Blood. 2019;134(S1):1599.
- Iacoboni G, Villacampa G, Martinez-Cibrian N, et al. Real-world evidence of tisagenlecleucel for the treatment of relapsed or refractory large B-cell lymphoma. Cancer Med. 2021;10(10):3214-3223.
- 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(14):1331-1342.
- Palomba ML, Gordon LI, Siddiqi T, et al. Safety and Preliminary Efficacy in Patients with Relapsed/Refractory Mantle Cell Lymphoma Receiving Lisocabtagene Maraleucel in Transcend NHL 001. Blood. 2020;136 (S1):10–11.
- Schuster SJ, Dickinson MJ, Dreyling MH, et al. Efficacy and safety of tisagenlecleucel (Tisa-cel) in adult patients (Pts) with relapsed/refractory follicular lymphoma(r/r FL): Primary analysis of the phase 2Elara trial. J Clin Oncol. 2021 39:15.suppl:7508-750.
- Jacobson C, Chavez JC, Sehgal AR, et al. Primary Analysis of Zuma-5: A Phase 2 Study of Axicabtagene Ciloleucel(Axi-Cel) in Patients with Relapsed/Refractory (R/R) Indolent Non-Hodgkin Lymphoma (iNHL). Blood. 2020;136 (S1):40–41.
- Ghione P, Patel A, Bobillo S, et al. A comparison of clinical outcomes from zuma-5 (axicabtagene ciloleucel) and the international scholar-5 external control cohort in relapsed/refractory follicular lymphoma (r/r fl). EHA 2021; June 9, 2021:#LB1904.
- Crump M, Neelapu SS, Farooq U, et al. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood. 2017;130(16):1800-1808.
- Martin P, Maddocks K, Leonard JP, et al. Postibrutinib outcomes in patients with mantle cell lymphoma. Blood. 2016;127(12):1559-63.
- Munshi NC, Anderson LD Jr, Shah N, et al. Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma. N Engl J Med. 2021;384(8):705-716.
- Roex G, Timmers M, Wouters K, et al. Safety and clinical efficacy of BCMA CAR-T-cell therapy in multiple myeloma. J Hematol Oncol. 2020;13(1):164.
- Moreau P, Kumar SK, San Miguel J, et al. Treatment of relapsed and refractory multiple myeloma: recommendations from the International Myeloma Working Group. Lancet Oncol. 2021;22(3):e105-e118.
- Ahmed G, Hamadani M , Shah NN, et al. CAR T-cell therapy for secondary CNS DLBCL. Blood Adv. 2021;5(24):5626-5630.
- Vercellino L, Di Blasi R, Kanoun S, et al. Predictive factors of early progression after CAR T-cell therapy in relapsed/refractory diffuse large B-cell lymphoma. Blood Adv. 2020;4(22):5607-5615.
- Rabinovich E, Pradhan K, Sica RA, et al. Elevated LDH greater than 400 U/L portends poorer overall survival in diffuse large B-cell lymphoma patients treated with CD19 CAR-T cell therapy in a real world multi-ethnic cohort. Exp Hematol Oncol. 2021;10(1):55.
- Westin JR, Tam CS, Borchmann P, et al. Correlative Analyses of Patient and Clinical Characteristics Associated with Efficacy in Tisagenlecleucel-Treated Relapsed/Refractory Diffuse Large B-Cell Lymphoma Patients in the Juliet Trial. Blood. 2019;134(suppl 1):Abstract 4103.
- Denlinger N, Bond D, Jaglowski S, et al. CAR T-cell therapy for B-cell lymphoma. Curr Probl Cancer. 2022;46(1):100826.
- Hayden PJ, Roddie C, Bader P, et al. Management of adults and children receiving CAR T-cell therapy: 2021 best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association (EHA). Ann Oncol. 2022;33(3):259-275.
- Yakoub-Agha I, Chabannon C, Bader P, et al. Management of adults and children undergoing chimeric antigen receptor T-cell therapy: best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE). Haematologica. 2020;105(2):297-316.
- Kamdar M, Solomon SR, Arnason JE, et al. Lisocabtagene Maraleucel (liso-cel), a CD19-Directed Chimeric Antigen Receptor (CAR) T Cell Therapy, Versus Standard of Care (SOC) with Salvage Chemotherapy (CT) Followed By Autologous Stem Cell Transplantation (ASCT) As Second-Line (2L) Treatment in Patients (Pts) with Relapsed or Refractory (R/R) Large B-Cell Lymphoma (LBCL): Results from the Randomized Phase 3 Transform Study. Blood. 2021;138 (Supplement 1): 91.
- Locke FL, Miklos DB, Jacobson C, et al. Primary Analysis of ZUMA-7: A Phase 3 Randomized Trial of Axicabtagene Ciloleucel (Axi-Cel) Versus Standard-of-Care Therapy in Patients with Relapsed/Refractory Large B-Cell Lymphoma. Blood. 2021;138 (Supplement 1):2.
- Bishop MR, Dickinson M, Purtil D, et al. LBA-6 Tisagenlecleucel Vs Standard of Care As Second-Line Therapy of Primary Refractory or Relapsed Aggressive B-Cell Non-Hodgkin Lymphoma: Analysis of the Phase III Belinda Study. Blood. 2021;138 (Supplement 2):LBA–6.
- Gonsalves WI, Buadi FK, Ailawadhi S, et al. Utilization of hematopoietic stem cell transplantation for the treatment of multiple myeloma: a Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus statement. Bone Marrow Transplant. 2019;54(3):353–367.
- Howell D, Smith A, Appleton S, et al. Multiple myeloma: routes to diagnosis, clinical characteristics and survival - findings from a UK population-based study. Br J Haematol. 2017;177(1):67–71.
- Kariyawasan CC, Hughes DA, Jayatillake MM, et al. Multiple myeloma: causes and consequences of delay in diagnosis. QJM. 2007;100(10):635-40.
- Snyder S, Chung KC, Jun MP, et al. Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma. Adv Ther. 2021;38(9):4659-4674.
- Kansagra A, Farnia S, Majhail N. Expanding Access to Chimeric Antigen Receptor T-Cell Therapies: Challenges and Opportunities. Am Soc Clin Oncol Educ Book. 2020;40:1-8.
- Gajra A, Jeune-Smith Y, Feinberg BA. Barriers to Referral for Chimeric Antigen Receptor T Cell (CAR-T) Therapies Among U.S. Community Hematologists/Oncologists (cH/O). Blood. 2021;138(S1):4010.
- Neelapu SS, Tummala S, Kebriaei P, et al. Chimeric antigen receptor T-cell therapy - assessment and management of toxicities. Nat Rev Clin Oncol. 2018;15(1):47-62.
- Mahmoudjafari Z, Hawks KG, Hsieh AA, et al. American Society for Blood and Marrow Transplantation Pharmacy Special Interest Group Survey on Chimeric Antigen Receptor T Cell Therapy Administrative, Logistic, and Toxicity Management Practices in the United States. Biol Blood Marrow Transplant. 2019;25(1):26-33.