Dr. Ansell on the Utility of Non–CAR T-Cell Therapies in Non-Hodgkin Lymphoma

Stephen M. Ansell, MD, PhD, chair, Lymphoma Group, Mayo Clinic, discusses the utility of non–CAR T-cell therapy options in non-Hodgkin lymphoma (NHL).

Historically, patients with NHL, particularly large B-cell lymphoma (LBCL), who progressed following autologous stem cell transplant had poor prognoses with limited treatment options, Ansell says. As such, palliative chemotherapy was often the only available option for this patient population.

However, several novel therapeutic approaches have emerged that have changed the treatment course for these patients, Ansell explains. Antibody-drug conjugates, such as polatuzumab vedotin-piiq (Polivy), can be used as single agents or in combination with chemotherapy. The monoclonal antibody tafasitamab-cxix (Monjuvi) is FDA approved for use in combination with lenalidomide (Revlimid) in patients with relapsed/refractory diffuse LBCL. Additionally, bispecific antibodies, as well as the XPO1 antagonist selinexor (Xpovio), are approved for use in LBCL, Ansell says.

These non–CAR T-cell therapies can be utilized in various sequences, Ansell explains. In the context of CAR T-cell therapy, some of these approaches can be used as bridging treatment to CAR T-cell therapy, after progression on CAR T-cell therapy, or instead of CAR T-cell therapy in patients who are ineligible for CAR T-cell therapy or whose disease histology limits the utility of CAR T-cell therapy, concludes Ansell.