Dr Leslie on Outpatient CAR T-Cell Therapy Programs for Hematologic Malignancies

Lori A. Leslie, MD, director, Indolent Lymphoma and Chronic Lymphocytic Leukemia Research Programs, John Theurer Cancer Center (JTCC), assistant professor, Hackensack Meridian School of Medicine, discusses the benefits of implementing CAR T-cell therapy programs for patients with hematologic malignancies and highlights the successes with administering CAR T-cell therapy that JTCC has experienced.

Since its inception, the Lymphoma Division at JTCC has been actively engaged with CAR T-cell therapy development, Leslie says. JTCC was involved with some of the first CAR T-cell therapy clinical trials for patients with lymphoma, which culminated in the FDA approval of CAR T-cell therapy in the third-line setting for patients with large-cell lymphoma, Leslie explains. Subsequently, researchers at JTCC participated in a pivotal study comparing CAR T-cell therapy with standard high-dose chemotherapy plus autologous stem cell transplant, Leslie says. This study demonstrated an improvement in progression-free survival and overall survival for patients with high-risk, relapsed diffuse large B-cell lymphoma, according to Leslie.

JTCC’s exploration of CAR T-cell therapy coincided with the challenges posed by the COVID-19 pandemic, which complicated efforts to administer CAR T-cell therapy in outpatient settings, Leslie notes. Despite these barriers, the JTCC Lymphoma Division is actively engaged in research to formally investigate the feasibility of outpatient CAR T administration, which could reduce extended hospital stays during treatment, Leslie says.

The success of these outpatient studies has motivated JTCC to become involved in initiatives aimed at increasing the accessibility of CAR T-cell therapy, according to Leslie. Treatment centers often experience logistical challenges that require CAR T-cell therapy to be exclusively administered in hospital settings, Leslie emphasizes. However, the increasing availability of outpatient CAR T-cell therapymay allow the establishment of CAR T-cell programs to be more feasible for these centers.

The Lymphoma Division at JTCC is also participating in clinical trials exploring the application of CAR T-cell therapy in the frontline setting for patients with large-cell lymphoma, Leslie notes. The potential impact of CAR T-cell therapy goes beyond large B-cell lymphoma, as these products are also gaining traction in follicular and marginal zone lymphoma, Leslie explains. As FDA-approved CAR T-cell therapies continue their expansion into various lymphoma subtypes, flexible approaches to administration of these products can ensure that more eligible patients can access this treatment, Leslie concludes.