Jason Westin, MD, FASCP, on Axi-cel's Place in the Evolving Landscape of Care for Large B-cell Lymphoma

“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.

Click here for more coverage of ASCO 2023.

REFERENCE
Westin J, Oluwole OO, Kersten MJ, et al. 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. Presented at: the American Society of Clinical Oncology (ASCO) 2023 Annual Meeting, held June 2-6, in Chicago, Illinois. Abstract #LBA107