CAR T-Cell Therapy for the Treatment of R/R Mantle Cell Lymphoma

Andre Goy, MD, MS, the physician-in-chief at Hackensack Meridian Health Oncology Care Transformation Service and chairman and chief physician officer at John Theurer Cancer Center, discusses the results of the ZUMA-2 study of the chimeric antigen receptor (CAR) T-cell therapy

brexucabtagene autoleucel (formerly KTE-X19; Tecartus) for the treatment of patients with relapsed or refractory mantle cell lymphoma. This study led to the approval of brexucabtagene autoleucel in this setting.

Goy explained that in terms of pharmacokinetics, patients with a durable response to brexucabtagene autoleucel of 12 or more months had a greater peak of CAR T cells after infusion than those who had an early relapse, which was expected. Additionally, there was less CAR T-cell expansion in heavily pretreated patients.

As the disease is aggressive, it is not necessary to see detectable, persistent CAR T cells, Goy said. In fact, one-third of participants had recovered levels of B cells after 1 year. These results are consistent with what has been seen previously with aggressive lymphoma. According to Goy, this shows a durable response in a hard-to-treat population.

In a small study of 30 patients who were treated with another CAR T-cell therapy, lisocabtagene ciloleucel, in patients with mantle cell lymphoma showed a high response rate. Additionally, fewer toxicities and grade 3 cytokine release syndrome and neurotoxicity events were seen, which are common concerns with CAR T-cell therapy. This could be an appealing alternative for the elderly patient population due to its durable response rate with clinical benefits, Goy suggested.