Expert Explains Potential Long-term Impact of Yescarta CAR-T Cell Therapy For Patients with Lymphoma
Dr. Caron A. Jacobson discusses the potential long-term impact of Yescarta for patients with relapsed or refractory indolent non-Hodgkin lymphoma and how it could turn an incurable disease into something curable.
BY Caron A. Jacobson, MD
PUBLISHED June 17, 2020
An interim analysis of the phase 2 ZUMA-5 study indicated that the CAR-T cell therapy Yescarta (axicabtagene ciloleucel) had a significant and durable response in patients with relapsed or refractory indolent non-Hodgkin lymphoma, but requires more observation to see how long the responses can last, according to data presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program.
In an interview with CancerNetwork®, a sister publication to CURE®, Dr. Caron A. Jacobson, of the Dana-Farber Cancer Institute, discussed the implications of this study.
This was a heavily pretreated population of patients, so on average patients had had 3 or more lines of therapy, so really this was 4th line for most patients, but we know that once we hit 3rd line and beyond the available options for follicular lymphoma and marginal cell lymphoma. Once you hit 3rd line and beyond, that's when the remission duration starts to get shorter and shorter.
So, the number of complete responses are generally lower and the patients are expected to relapse before a year of that line of therapy, so the fact that we saw so many complete responses and that so many are ongoing past a year is already an improvement past this line of therapy. Though not every follicular lymphoma patient will get to a 3rd line of therapy, many patients will have this disease for 20 or 30 years, they can be observed for a while, they may need only one or two lines of therapy in their lifetime, but for that group of patients that gets to the point of needing a third line we do need treatments that can give more durable responses.
So, I think that's what we can say right now. We need longer follow up in this disease because this is a disease known to respond for multiple years to therapy and has a high risk of relapse and these relapses can happen late, but that really means that with conventional therapies these are incurable diseases so it may very well be true that these patients and ongoing response (to treatment) at this point are at risk of releasing as time goes on. But if they don't, we've just discovered a therapy that can turn an incurable disease into a curable disease for a subset of patients, which would be remarkable.