Highlights in Non-Hodgkin Lymphoma From ASCO 2020

Michael D. Jain, MD, PhD

Disclosures

June 23, 2020

Dr Michael D. Jain, lymphoma expert at the University of South Florida and H. Lee Moffitt Cancer Center and Research Institute, discusses potentially practice-changing data in the management of non-Hodgkin lymphoma from the ASCO 2020 virtual annual meeting.

Highlights include a presentation on ZUMA-5, the latest in the ZUMA series of trials of CAR T cells in relapsed/refractory lymphoma. Here, as in the earlier trials, axicabtagene ciloleucel achieved a significant and durable benefit.

Next, Dr Jain looks at phase 1/2 trial data on the first CD19/22 dual-targeting CAR T-cell therapy, here used in combination with pembrolizumab in patients with relapsed/refractory diffuse large B-cell lymphoma. Responses to the dual-targeting CAR T approach were comparable to those of previous CAR T studies and were associated with a good safety profile.

In the CAR T-cell era, the question arises as to whether a stem cell transplant is appropriate in patients who relapse on chemo-immunotherapy and whether the timing of the transplant affects outcomes. Dr Jain believes that the results of a CIBMTR registry study answering these questions could be practice-changing.

Finally, Dr Jain discusses a phase 2 study that examined the combination of Bcl-2 inhibition and chemoimmunotherapy in Richter syndrome, which is associated with a poor prognosis. Although it is a small study, 65% of patients achieved a complete response. Dr Jain suggests that this strategy may prove a viable option before turning to the use of whole-brain radiotherapy in primary CNS lymphoma.

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