Frederick Lock, MD, spoke about how axicabtagene ciloleucel has improved survival in patients with large B-cell lymphoma.
Frederick Locke, MD, vice chair of the Department of Blood and Marrow Transplant and Cellular Immunotherapy as well as program co-leader of Immuno-Oncology at Moffitt Cancer Center in Tampa, Florida, spoke to CancerNetwork® about the use of axicabtagene ciloleucel (Yescarta; axi-cel) for patients with relapsed/refractory large B-cell lymphoma (LBCL) has improved survival. Recently, the therapy was approved for patients who were pretreated with frontline chemoimmunotherapy and relapsed within 12 months based on the phase 3 ZUMA-7 trial (NCT03391466),1 which compared axi-cel with standard of care, with a median event-free survival improvement of 8.3 months (95% CI, 4.5-15.8) vs 2.0 (95% CI, 1.6-2.8) with standard of care (HR, 0.398; 95% CI, 0.308-0.514; P <.0001).2
This approval addresses an unmet need, which is patients who relapse within 12 months of initial therapy. Patients with LBCL who progress within 12 months of initial therapy have overall poorer outcomes. We now know that if we can get them CAR T-cell therapy with axi-cel as a second-line treatment, we’re ultimately offering the best treatment for the patients earlier. On the trial that led to this approval for axi-cel in the second line, 40% of patients who were randomized to receive axi-cel remain without progression, alive, and not needing other therapy 2 years after the treatment. That’s compared with 16% of patients who went down the path of chemotherapy and if they responded, got an autologous transplant. The key here is that we should give the best treatment available to patients earlier in the disease course. That requires early referral.