Advancements in CAR T, GVHD Shine at 2024 TCT Tandem Meetings

The 2024 Transplantation and Cellular Therapy Tandem Meetings took place in San Antonio, Texas from February 21 to 24, 2024, where experts in the field of hematologic oncology met to learn and share results of the latest research.

While the latest findings in stem cell transplantation often take center stage, some of the most compelling data came from studies on chimeric antigen receptor (CAR) T-cell therapies. These studies included the CARTITUDE-2 study (NCT04133636) of ciltacabtagene autoleucel (cilta-cel; Carvykti) in relapsed or refractory multiple myeloma and the TRANSCEND CLL 004 (NCT03331198) and TRANSCEND NHL 001 (NCT02631044) trials of lisocabtagene maraleucel (liso-cel; Breyanzi).

Developments in the graft-vs-host disease (GVHD) space also were among some of the most anticipated at the meetings. These included promising data from a retrospective analysis showing that Orca-T may have an advantage over posttransplant cyclophosphamide regarding survival in GVHD.

CAR T-cell attack cancer cell and healthy cells © LASZLO - stock.adobe.com

Spotlight on CAR T-Cell Therapies

• Findings from the phase 2 CARTITUDE-2 trial (NCT04133636) showed that cilta-cel delivered deep, durable responses and up to a 100% overall response rate (ORR) in patients with relapsed/refractory multiple myeloma.
• Liso-cel demonstrated strong potential as a new treatment option for patients with chronic lymphocytic leukemia or small lymphocytic lymphoma who were unresponsive to other treatments, according to findings from the phase 1/2 TRANSCEND CLL 004 trial.
• Improvements in response and survival were observed in patients with high-risk relapsed or refractory mantle cell lymphoma treated with liso-cel, according to findings from a subgroup analysis of the TRANSCEND NHL 001 trial.
• Immune engager therapies such as bispecific antibodies showed the best response and progression-free survival in patients with multiple myeloma who had a relapse following treatment with idecabtagene vicleucel (ide-cel; Abecma), according to a retrospective real-world study.

Tumor microenvironment background with cancer cells, T-Cells, nanoparticles, molecules, and blood vessels. Oncology research concept: © ratatosk - stock.adobe.com

Tackling Graft-vs-Host Disease

• Michael Scordo, MD, medical oncologist, bone marrow transplant specialist, and cellular therapist at Memorial Sloan Kettering Cancer Center, discussed personalizing dosages of antithymocyte globulin to improve chronic GVHD-free relapse-free survival in patients undergoing hematopoietic stem cell transplants.
• Combining belumosudil (Rezurock) and ruxolitinib (Jakafi) showed improvements in response and tolerability in patients with steroid-refractory or -dependent chronic GVHD, according to findings from a retrospective analysis.
• Additionally, the combination of ruxolitinib and belumosudil showed a 55% ORR in a small, single center retrospective analysis that included 20 patients with GVHD.
• Antifungal prophylaxis with azoles did not impact outcomes of ruxolitinib for GVHD, according to findings from the phase 3 REACH2 study (NCT02913261).
• Orca-T delivered improved survival rates vs prophylaxis with posttransplant cyclophosphamide for GVHD in patients with hematologic malignancies undergoing stem cell transplantation with matched unrelated donors receiving myeloablative conditioning, according to findings from a retrospective study.
• Patients with chronic GVHD who received ruxolitinib were able to benefit from treatment with the help of dose adjustments, with one-third receiving therapy for over 1 year, according to real-world evidence.
• Results from a phase 2 trial presented showed that ruxolitinib cream (Opzelura) demonstrated safety and efficacy in a small group of patients with cutaneous GVHD.