VIDEO: Impact of CAR T-cell therapy on DLBCL care

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

When I discuss CAR T-cell therapy with my patients, it really sounds like science fiction to them. It sounds like "Star Trek" and it sounds like I'm saying something that may be available in the distant future but, yep, no CAR T medicine here today. We call it a living medicine because we're actually re-infusing living cells back into, sometimes, cells that can live for months or even years in some cases. Tylenol doesn't last in years for you but CAR T can last for a long time in the patient and have had profound impact especially on the subsets of our patients. So, you know, they've been approved for third-line therapy for already now a few years and that impact is tremendous for some patients. Probably they are putting 35% or 40% of patients who had otherwise, you know, relapse and refractory disease into durable remissions. Probably a good chunk of those patients are cured. So, I mean, that is really what we refer to as an incurable setting in the third-line DLBCL and it was incurable in 2010 and now we are curing a significant fraction of them, probably more than third. I mean, that's, I think, how we are supposed to define miracles. Miracles are things that you think cannot be done being done. You know, splitting an ocean is pretty miraculous. Curing an incurable disease should be treated in the same way. So that is an awesome advance in third-line therapy.

Now, we have these two trials, the ZUMA-7 trial for axi-cel and the liso-cel TRANSFORM trial, shown that in second-line DLBCL, especially the early relapsers, folks that relapse within 12 months after standard frontline chemo, I should say relapse or refractory patients that get no response to R-CHOP as well, having really a tremendous PFS benefit either with axi-cel or with liso-cel. Those two trials, ZUMA-7 and TRANSFORM done a little bit differently so we can't really equate them but both with the same overlying answer that CAR T-cells for early relapsers appear to be efficacy superior to the standard of care which was platinum chemo and transplant. And I would say probably better in safety and fewer adverse events overall. The toxicities are quite different but overall, you know, we say a person getting autotransplant will be out of work for months because they just won't be feeling up to it for a long time after an autotransplant, whereas after CAR T-cell, it's conceivable people are back at work within weeks. So I would call it a win-win, an efficacy win, and a safety win. So a great impact for patients with CAR T-cells in the third-line and in the second-line with early-relapsing DLBCL.