Expert Discusses Challenges of Using CAR T-Cell Therapy to Treat Diffuse Large B-Cell Lymphoma

At the 2019 School of Hematological Oncology, OncLive^®, a sister publication of Oncology Nursing News^®, sat down with David G. Maloney, MD, PhD, medical director of cellular immunotherapy at the Immunotherapy Integrated Research Center at the Fred Hutchinson Cancer Research Center, to discuss recent challenges in using CAR T-cell therapy for patients with diffuse large B-cell lymphoma.

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The biggest issue we're facing right now is we need to get patients earlier in their treatment course. If you just analyze some of their results with ZUMA-1, which was using axicabtagene ciloleucel, or Yescarta, in that setting the patients who were in the lowest quartile of tumor burden had very high overall response rates, but they also had durable remission. So, their chance of being in remission was quite a bit higher at 1 year compared to the quartile that had the highest degree of tumor burden.

At the same time, those patients have less toxicity. They have less serious cytokine release syndrome and less serious neurologic toxicity. So just by trying to find patients earlier before they failed every possible option or even getting the patients into better disease response before, they come to CAR T cells can greatly improve the outcome.