Dr. Lunning on the Efficacy of Axi-Cel in Relapsed/Refractory Indolent Non-Hodgkin Lymphoma

Matthew Lunning, DO, an assistant professor of internal medicine in the Division of Oncology and Hematology, College of Medicine, at University of Nebraska Medical Center, discusses the efficacy of axicabtagene ciloleucel (axi-cel; Yescarta) in patients with relapsed/refractory indolent non-Hodgkin lymphoma.

The phase 2 ZUMA-5 trial (NCT03105336), which examined the CAR T-cell therapy in patients with advanced non-Hodgkin lymphoma, offered data on a subset of patients with follicular lymphoma who had long enough follow-up, Lunning says. The study was interesting in that it not only enrolled patients with follicular lymphoma, who comprised much of the patient population, but also marginal zone lymphoma (MZL), he says.

When examining overall response rates in the population that drove durability, investigators observed a notable difference between the follicular lymphoma and MZL cohorts. While some believe that the follow up was not long enough in the MZL cohort, several early progression events occurred that were unusual for what one would normally expect for MZL, Lunning explains. 

However, the survival curves indicated that patients may respond to other therapies following CAR T-cell therapy, an achievement that has proven difficult in diseases such as mantle cell lymphoma, and diffuse large B-cell lymphoma, Lunning concludes.