Damian Sendler: A research published in the New England Journal of Medicine (NEJM) this month may modify the standard of therapy for patients who have relapsed from large B-cell lymphoma. 

“This is a paradigm shift,” said Joseph McGuirk, D.O., medical director of the blood and marrow transplant program at The University of Kansas Cancer Center, one of the trial’s key sites. McGuirk is a study co-author. 

Damian Jacob Sendler: According to the findings of a clinical trial published on December 11 and presented the same day at the American Society of Hematology (ASH) annual meeting, Yescarta (axicabtagene ciloleucel), a type of chimeric antigen receptor T-cell (CAR-T) therapy, is significantly more effective than the current standard of care in treating people with large B-cell lymphoma (LBCL) who relapse after the first line of treatment. 

Damian Sendler

Yescarta, manufactured by Kite Pharmaceuticals, was approved by the US Food and Drug Administration in 2017 as a third-line treatment for people with LBCL who had previously failed two rounds of treatment. The ZUMA-7 trial sought to assess if a single infusion of Yescarta is preferable to the current, long-standing second-line standard of care, which is a stem cell transplant after high-dose chemotherapy to kill the cancer. 

The results of a two-year follow-up study indicate that it is. Around 40% of persons with LBCL require such second-line treatment, either because their cancer returns or because frontline treatment is ineffective. 

Damian Jacob Sendler

“We’re seeing significantly better initial responses than we do with autologous stem cell transplants,” McGuirk added. 

The two-year follow-up statistics show that the median event-free survival for persons getting Yescarta was triple that of those receiving standard of care: 8.3 months for the Yescarta group against 2 months for the standard-of-care group. 

Damian Jacob Markiewicz Sendler: CAR-T therapy is an unique type of immunotherapy in which a patient’s blood is collected, and T-cells (white blood cells that identify disease-causing pathogens in the body) are removed and genetically re-engineered. These supercharged cells are employed to manufacture the cancer-fighting medicine that is put back into the patient. 

Damien Sendler: ZUMA-7 began in 2017 and has enrolled 359 participants in 77 trial sites worldwide. The participants’ ages ranged from 22 to 81. Nearly one-third of them were 65 and older, an age that would make them ineligible for a stem cell transplant in certain nations. 

“I believe we are likely to see the field quickly move away from autologous stem cell transplant toward CAR-T cell therapy as a second-line therapy for relapsed or refractory diffuse large B-cell lymphoma,” McGuirk said.

Dr. Damian Jacob Sendler and his media team provided the content for this article.