Dr Kambhampati on the Potential Use of Brexu-Cel in Earlier Treatment Lines in MCL

Swetha Kambhampati, MD, hematologist/oncologist, assistant professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, discusses how findings from a subgroup analysis of investigating the use of brexucabtagene autoleucel (Tecartus; brexu-cel) in relapsed/refractory mantle cell lymphoma (MCL) may support the continued exploration of this agent in earlier lines of therapy.

This real-world study identified patients in the CIBMTR observation database whose disease had previously progressed on the BTK inhibitor, bendamustine (Avastin), or autologous stem cell transplantation (ASCT). Patients were also required to have received either up to 2 prior lines of therapy, or 3 or more prior lines.

Results showed that patients who received 1 or 2 prior lines of treatment had higher responses and were more likely to achieve a complete response with brexu-cel vs those who had received 3 or more lines of treatment, Kambhampati reports. Moreover, a multivariate analysis revealed that exposure to prior BTK inhibitors or bendamustine did not affect the efficacy or safety of brexu-cel treatment. This was observed even after accounting for other baseline characteristics, she adds. Notably, these real-world safety and efficacy outcomes reflected those observed in clinical trials, such as the phase 3 ZUMA-2 study (NCT02601313), Kambhampati says.

Overall, the findings from this extensive real-world study provide compelling evidence to consider treatment with brexu-cel in earlier treatment lines, Kambhampati continues. The association between elevated response rates and lower levels of prior treatment in this population indicates that early administration of brexu-cel could potentially enhance treatment outcomes, she says. This strategy is also mechanistically supported in patients who have undergone fewer prior treatments have enhanced T-cell quality. Consequently, this could improve patient responses to brexu-cel, Kambhampati explains.

Further evaluation is necessary to validate the benefits of using brexu-cel in the upfront setting, and to refine treatment strategies in this space, Kambhampati concludes.

Dr Kambhampati had no relationships to disclosure.