Dr. Jacobson on the Safety Profile of Axi-Cel in Relapsed/Refractory Indolent Lymphoma

Caron Jacobson, MD, medical director, Immune Effector Cell Therapy Program, and physician, Dana-Farber Cancer Institute, assistant professor of medicine, Harvard Medical School, discusses the safety profile of axicabtagene ciloleucel (axi-cel; Yescarta) in relapsed/refractory indolent non-Hodgkin lymphoma (iNHL).

An interim analysis of the phase 2 ZUMA-5 trial presented at the 2020 ASCO Virtual Scientific Program showed that axi-cel elicited significant and durable clinical benefit in patients with relapsed/refractory follicular lymphoma and marginal zone lymphoma (MZL).

Axi-cel had a favorable safety profile in the cohort of patients with follicular lymphoma. As such, axi-cel could be considered for outpatient dosing, pending further positive results, says Jacobson.

About 23% of patients with follicular lymphoma did not experience any-grade cytokine release syndrome (CRS) and of those who did, 7% was grade 3 or higher, says Jacobson. Notably, the median time to onset of CRS was around 4 days compared with 2 days in large-cell lymphoma. Additionally, 15% of patients in this cohort experienced grade 3 or higher neurologic toxicities.

Among patients with MZL, the rates of high-grade CRS and neurologic events were 13% and 38%, respectively, says Jacobson. These findings are in line with what has been observed in large-cell lymphoma.