Dr. Neelapu on Third-Line CAR T-Cell Therapy in Large B-Cell Lymphoma

Sattva Neelapu, MD, professor of lymphoma and myeloma at The University of Texas MD Anderson Cancer Center, discusses the use of CAR T-cell therapy in the third-line setting for patients with large B-cell lymphoma.

Axicabtagene ciloleucel (axi-cel; Yescarta) and tisagenlecleucel (Kymriah) are currently the only CAR T-cell products approved for patients with relapsed/refractory large B-cell lymphoma who have failed 2 or more lines of systemic therapy. This indication includes the histologies of diffuse large B-cell lymphoma and high-grade B-cell lymphoma, explains Neelapu.

Currently, these products are used in the third-line setting and beyond, typically after patients with B-cell lymphoma have failed the frontline chemotherapy and the second-line autologous stem cell transplantation. Previously, the outcomes of these patients had been pretty dismal with a median survival of 46 months, according to Neelapu. Updated 2-year data for axi-cel and tisagenlecleucel show durable responses, Neelapu says.