Jason Westin, MD, FASCP, on Axi-cel's Place in the Evolving Landscape of Care for Large B-cell Lymphoma
The director of the Lymphoma Clinical Research Program at University of Texas MD Anderson Cancer Center discussed recent and ongoing studies that are upending the paradigm in LBCL care.
“I think one of the big takeaways from the primary overall survival analysis is that more patients live longer if they're treated in second-line with axi-cel... The prior paradigm of ‘Let's see if the patient will respond to chemo and then if not, okay, now we'll go for CAR T-cell therapy’—that's been conclusively shown to be an inferior approach and I think it's time to move on as a field and acknowledge that CAR T-cells are superior to chemo and stem cell transplant.”
Recent data from several clinical trials have initiated discussions about a potential paradigm shift in the treatment landscape for large B-cell lymphoma (LBCL). Among the relevant studies are the phase 3 POLARIX clinical trial (NCT03274492), which is evaluating the first-line standard of care (SOC) chemotherapy regimen for diffuse LBCL against a regimen including antibody-drug conjugate polatuzumab vedotin, and the phase 3 ZUMA-7 clinical trial (NCT03391466), which is evaluating second-line SOC platinum-based chemotherapy against Kite’s axicabtagene ciloleucel (axi-cel; Yescarta). Of note, superior outcomes in overall survival (OS) for patients treated with axi-cel in ZUMA-7 were recently reported at the American Society of Clinical Oncology (ASCO) 2023 Annual Meeting, held June 2-6, in Chicago, Illinois, and have solidified the case for making the cell therapy a new SOC in the second-line treatment setting.
Jason Westin, MD, FASCP, the director of the Lymphoma Clinical Research Program at University of Texas MD Anderson Cancer Center, presented the data at ASCO in a talk entitled “Primary overall survival analysis of the phase 3 randomized ZUMA‑7 study of axicabtagene ciloleucel versus standard‑of‑care therapy in relapsed/refractory large B-cell lymphoma”. In an interview with CGTLive™, Westin gave an overview of the current landscape of care for diffuse LBCL and how the new axi-cel OS data, recent POLARIX data, and event-free survival data from research on Bristol Myers Squibb’s lisocabtagene maraleucel (liso-cel; Breyanzi) are contributing to a rapid evolution of this landscape. In addition, he went over the results he presented at the conference in more detail and spoke about the key importance of OS as a measure of efficacy. Westin also mentioned ZUMA-23, a separate phase 3 clinical trial (NCT05605899) evaluating axi-cel's potential as a first-line treatment for patients with high-risk LBCL.
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