Manali Kamdar, MD, on Sequencing of Treatment in Third-Line R/R LBCL
The clinical director of lymphoma services at the University of Colorado discussed the choice between treating patients with liso-cel or bispecific T-cell engagers.
This is the second part of an interview with Manali Kamdar, MD. For the first part, click here.
“I think that is potentially the main question: Based on the 5-year follow-up of the TRANSCEND-NHL-001 study demonstrating a curative potential of liso-cel, how [do we] pitch it against CD20 BiTEs?”
Current treatment options for patients with third-line relapsed/refractory (r/r) large B-cell lymphoma (LBCL) include Bristol Myers Squibb’s lisocabtagene maraleucel (liso-cel, marketed as Breyanzi), an autologous CD19-directed chimeric antigen receptor (CAR) T-cell therapy, and CD20-bispecific T-cell engagers (BiTEs), such as epcoritamab (Epkinly) and Glofitamab (Columvi). Liso-cel was approved by the FDA for treatment in this setting based on results from the TRANSCEND-NHL-001 clinical trial (NCT02631044). Notably, 5-year survival data from patients treated in the LBCL cohort in TRANSCEND-NHL-001 were recently presented by Jeremy S. Abramson, MD, the director of the Lymphoma Program and the Jon and Jo Ann Hagler Chair in Lymphoma at the Massachusetts General Hospital Cancer Center, at the 66th American Society of Hematology (ASH) Annual Meeting and Exposition, held December 7-10, 2024, in San Diego, California.
After the conference, CGTLive® spoke with Manali Kamdar, MD, the associate professor of medicine–hematology and clinical director of lymphoma services at the University of Colorado, about the implications on this newly reported data for the treatment landscape in third-line r/r LBCL. Kamdar pointed out that now one of the major questions facing treating physicians is the sequencing of treatment options: whether patients in the third-line should be treated with liso-cel or CD20 BiTEs first? Kamdar weighed the pros and cons of each of these 2 options, noting that liso-cel has longer-term follow-up data available than do CD20 BiTEs. She pointed out that that currently, data indicates that liso-cel has curative potential, and that it has the advantage of being a one-time, one-and-done treatment. On the other hand, Kamdar emphasized that CD20 BiTEs are able to be used off-the-shelf, without a lengthy manufacturing time, unlike CAR-T, and that caregiver requirements for CD20 BiTEs may be less stringent in the future because of the lower risks of cytokine release syndrome and neurotoxicity associated with CD20 BiTEs in comparison to CAR-T.
For more coverage of ASH 2024, click here.
