Relapsed, Refractory Follicular Lymphoma: CAR-T Cell Therapy Shows Promise

Axicabtagene ciloleucel (axi-cel) appears to be both safe and effective for treating relapsed/refractory follicular lymphoma (FL), according to research presented at the European Hematology Association (EHA) 2021 Virtual Congress.

The phase 2 ZUMA-5 trial (ClinicalTrials.gov Identifier: NCT03105336) previously demonstrated that axi-cel, a chimeric antigen receptor (CAR)-T cell therapy targeting CD19, showed a both high overall response rate and long duration of response in patients with relapsed/refractory FL, including in patients with high-risk disease.

In this presentation, the authors reported comparative clinical outcomes from updated ZUMA-5 data and the international SCHOLAR-5 cohort.

Data from the SCHOLAR-5 cohort were taken from 7 institutions, and included data from a previous trial of idelalisib; patients in SCHOLAR-5 had received a third-line or later therapy after July 2014. Patient characteristics were balanced between the ZUMA-5 and SCHOLAR-5 cohorts.

Overall, data from 86 patients in ZUMA-5 and 85 patients in SCHOLAR-5 were included; the median follow-up times were 23.3 months and 26.2 months, respectively. Patients in the SCHOLAR-5 cohort had more patients with an Eastern Cooperative Oncology Group score of 1 at baseline, despite attempts to match characteristics.

In patients who had received at least 2 prior therapy lines, the overall response rates were 49.9% in SCHOLAR-5 vs 94.2% in ZUMA-5 (odds ratio, 16.2; 95% CI, 5.6-46.9). The median progression-free survival and overall survival periods were not reached in ZUMA-5, and were 12.7 months and 59.8 months, respectively, in SCHOLAR-5; the corresponding hazard ratios for progression-free and overall survival were 0.30 (95% CI, 0.18-0.49) and 0.42 (95% CI, 0.21-0.83), respectively.

“These data support that axi-cel represents a significant improvement in treatment options for patients with relapsed/refractory FL,” the presenter said.

Disclosure: The presenter declared affiliations with AstraZeneca, Kite, A Gilead Company, Gilead, Abbvie, Bristol Myers Squibb, MorphoSys, Novartis, Takeda, TG Therapeutics, Janssen.

Reference

Ghione P, Anik 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). Paper presented at: European Hematology Association 2021 Virtual Congress; June 2021; Abstract LB1904.

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