Mazyar Shadman, MD, on Investigating Treatment Choices With CAR-T and Auto-HSCT in LBCL

“When it comes to patients with primary refractory disease or relapse within the first 12 months, the goal of therapy should be CAR-T therapy...We do see patients that come to us, and they have indication for CAR-T therapy, but they had a good response to chemo in form of a CR. And we think in those patients, it's worth having a conversation about auto transplant being an alternative option, or maybe something they can try, knowing that CAR-T therapy could be used in the later lines of therapy.”

In participants with relapsed large B-cell lymphoma (LBCL) who achieve a complete or partial response with bridging chemotherapy, treatment with auto-hematopoietic stem cell transplant (HSCT) is associated with a lower relapse rate and an improved progression-free survival compared to chimeric antigen receptor (CAR) T-cell therapy in a population with LBCL naïve to both treatments, including in patients with early treatment failure (within 12 months).

These data, from a retrospective analysis, were presented by Mazyar Shadman, MD, MPH, associate professor, clinical research division, and attending physician, hematologic malignancies, Fred Hutch Cancer Center, and associate professor, medical oncology division, University of Washington School of Medicine, at the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition, held December 9-12, in San Diego, California.

CGTLive spoke with Shadman to learn more about the implications of the analysis. He stressed that these data validate existing practices and confirm the use of auto-HSCT as standard of care for chemo-sensitive patients who relapse after 12 months, but shared that it's worth a conversation to consider auto-HSCT instead of CAR-T with patients that responded to bridging therapy.

Click here to read more coverage of ASH 2023.

REFERENCE

Shadman M, Wooahn K, Kaur M, et al. Autologous transplant (auto-HCT) is associated with improved clinical outcomes compared to CAR-T therapy in patients (pts) with large B-cell lymphoma (LBCL) achieving a complete remission. Presented at: 2023 ASH Annual Meeting, December 9-12; San Diego, California. Abstract #781