Jason Westin, MD, FASCP, on the Potential Impact of Predicting Toxicity for CAR-T Treatment

“One of the limitations of CAR T-cells is their availability both in terms of geography and in terms of treatment setting. There are certain specialized centers that are able to deliver CAR T-cells mainly due to the management of potential toxicities. This is not a therapy that's available in [just] any practice because if things go wrong, they can go wrong in a hurry, and there is a need for inpatient management and potentially expert care. Having the ability to predict better which patients might have those toxicities and therefore extend those patients to specialized centers—and if patients are predicted not to have toxicities—that's something that potentially could allow more and more centers to treat those patients. But what I'd also say is that access to care is not just a geography thing, it's also related to the socioeconomic status of our patients. We've seen time and time again that certain demographics don't have as much access to specialized centers as others. Racial and ethnic minorities are often underrepresented in clinical trials and underrepresented at treatment centers that can deliver CAR T-cells. We need strategies to ensure that all of our patients have better access to these life-changing treatments.”

Jason Westin, MD, FASCP, the director of the Lymphoma Clinical Research Program at University of Texas MD Anderson Cancer Center, recently presented new data from the phase 3 ZUMA-7 clinical trial (NCT03391466) evaluating Kite’s axicabtagene ciloleucel (axi-cel; Yescarta) at the American Society of Clinical Oncology (ASCO) 2023 Annual Meeting, held June 2 to 6, in Chicago, Illinois. The presentation was primarily focused on a new analysis of overall survival data comparing the chimeric antigen receptor T-cell (CAR-T) therapy axi-cel to the current second-line standard of care chemotherapy for diffuse large B-cell lymphoma, but it also included an update on axi-cel's safety profile.

In an interview with CGTLive™, Westin discussed the new safety data he presented at the conference and spoke about how it compares to earlier reported safety data for axi-cel. He noted that the rate of grade 3 or higher cytokine release syndrome in ZUMA-7 was 6% and that the rate of grade 3 or higher neurologic toxicities was approximately 20%, both of which were generally in line with previous studies. Westin also discussed new findings with regard to hypogammaglobulinemia and infections. Next, he discussed how the ability to predict CAR-T toxicity for each individual patient could potentially help improve access to CAR-T therapies in the future, especially for patient demographics who are currently underrepresented in clinical trials and have limited access to specialized treatment centers.

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; June 2-6;Chicago, IL. Abstract #LBA107