Dr. Pagel on the Utility of CAR T-Cell Therapy in Relapsed/Refractory DLBCL – OncLive

John M. Pagel, MD, PhD, discusses the utility of CAR T-cell therapy in patients with relapsed/refractory diffuse large B-cell lymphoma.

John M. Pagel, MD, PhD, chief of the Hematologic Malignancies Program, and directorof theHematopoietic Cell Transplantation Program at Swedish Cancer Institute inSeattle, Washington, discussesthe utility of CAR T-cell therapy in patients with relapsed/refractorydiffuse large B-cell lymphoma (DLBCL).

Althoughautologous stem cell transplant (ASCT)is still used in DLBCL, it is important to understand that it is not a viable treatment option for the vast majority of patients who relapse, says Pagel. For example, if 60 out of 100 patients are cured, that means 40 patients will relapse, adds Pagel; of those 40patients,approximatelyhalfwill receivean ASCT. Patients will not get a transplant if theyare not chemotherapy sensitive or they mayhave comorbidities that do not allow them toundergo the procedure.

Moreover, only about half of patients who under transplant will achieve cure, adds Pagel. Patients who are not cured up front or by transplant still needaneffective treatment option that can provide a significant benefit. To this end, some newer agents have emerged for patients with relapsed disease in recent years. The biggest development has beenCAR T-cell therapy, says Pagel. This approach provides curative potential to patients who failed a transplant; were never able to get to transplant because they are not sensitive to chemotherapy; or were high-risk and refractory to up-frontrituximab (Rituxan) plus cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisonechemoimmunotherapy.

CAR T-cell treatments are very important for those patients, adds Pagel, as this approach can provide long-term survival to some of these patients, concludes Pagel.

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Dr. Pagel on the Utility of CAR T-Cell Therapy in Relapsed/Refractory DLBCL - OncLive