A new study has found beneficial results for patients with relapsed or refractory B-cell lymphoma who took a form of CAR T-cell therapy. The researchers believe the trial demonstrates that CAR-T therapy can be used as a second-line therapy in place of the current standard-of-care.
The drug is a chimeric antigen receptor (CAR) T cell therapy called axicabtagene ciloleucel, also known as axi-cel.
In the ZUMA-7 trial, axi-cel was given to 180 patients with early relapsed or refractory large B-cell lymphoma. Their outcomes were compared against 179 similar patients given the standard-of-care chemoimmunotherapy, followed by high-dose chemotherapy and autologous stem cell transplant in responders.
The results were published last week in New England Journal of Medicine, and presented concurrently at the American Society of Clinical Oncology (ASCO) annual meeting.
In this phase III trial, led by Dr Jason Westin from the University of Texas MD Anderson Cancer Center, USA, axi-cel was estimated to lower the four-year risk of mortality by 27.4% compared with standard therapy.
The team estimated that the four-year survival rate was 54.6% on axi-cel and 46% on standard care. They add that the overall survival and progression-free survival benefits of axi-cel “were consistent across all key patient subgroups”.
Dr Westin said: “This is the first randomised Phase III trial in nearly 30 years to improve overall survival with second-line curative therapy for patients with aggressive lymphoma.
“High-dose chemotherapy and stem cell transplant, the old standard, cured a small portion of patients but resulted in side effects for all.”
He added that patient quality of life improved faster on axi-cel than standard treatment, and “our results support axi-cel as a second-line treatment for these patients”.
Westin JR, Oluwole OO, Kersten MJ, Miklos DB, Perales MA, Ghobadi A, Rapoport AP, Sureda A, Jacobson CA, Farooq U, van Meerten T, Ulrickson M, Elsawy M, Leslie LA, Chaganti S, Dickinson M, Dorritie K, Reagan PM, McGuirk J, Song KW, Riedell PA, Minnema MC, Yang Y, Vardhanabhuti S, Filosto S, Cheng P, Shahani SA, Schupp M, To C, Locke FL; for the ZUMA-7 Investigators and Kite Members. (2023) “Survival with Axicabtagene Ciloleucel in Large B-Cell Lymphoma.” New England Journal of Medicine, doi: 10.1056/NEJMoa2301665
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