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CAR T-cell case study: Sequencing therapies for patients with high-risk DLBCL

Jul 25, 2023
Learning objective: After reading this article, learners will be able to cite developments in CAR T-cell therapy in patients with diffuse large B cell lymphoma.

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Here, we share a presentation by Ulrich Jӓger, Medical University of Vienna, Vienna, AT, on a case study to evaluate sequencing therapies for patients with high-risk diffuse large B cell lymphoma (DLBCL).

The Lymphoma Hub has previously covered sequencing therapies for patients with high risk DLBCL.

In this presentation, Jӓger shares a case study from 2019 of a 59-year-old female patient with DLBCL and the treatment decisions leading to chimeric antigen receptor (CAR) T-cell therapy, changes from 2019 to 2022 onwards in the algorithm for patients with DLBCL in clinical routine (Figure 1), and results in relapsed/refractory (R/R) patients with low-risk DLBCL treated with CAR T-cell therapy, presented at the European Hematology Association (EHA) 2023 Hydrid Congress (Figure 2).

Figure 1. Selection algorithm for patients with DLBCL in clinical routine: Austrian CAR T-cell Network* 

*Adapted from Greinix, et al.1


Figure 2. Probability of OS and PFS of patients with R/R LBCL infused with commercial CAR T-cell compounds* 

CAR, chimeric antigen receptor; CI, confidence interval; LBCL, large B-cell lymphoma; OS, overall survival; PFS, progression-free survival; R/R, relapsed/refractory
*Adapted from Rudzki, et al.2
Data from 65 patients treated with axicabtagene ciloleucel or tisagenlecleucel.

Watch or download the presentation to learn more about the understanding of CAR T-cell therapy in patients with DLBCL, including:

  • A real-world evidence case study of a patient with DLBCL treated in 2019 according to the algorithm for patients with DLBCL in clinical routine.
  • The key changes to the algorithm from 2019 to 2022 onwards, focusing on the removal of the requirement of no central nervous system (CNS) involvement in their diagnosis.
  • Data presented from the 64th American Society of Hematology (ASH) Annual Meeting and Exposition on progression-free survival and overall survival in low-risk patients with DLBCL treated with CAR T-cell therapy.

Key points

  • Special populations, such as patients with secondary CNS lymphoma, can be included in CAR T-cell treatments.
  • Secondary CNS lymphoma can be successfully treated with CAR T-cell therapy.
  • Sequencing capabilities have rapidly advanced since 2019 and earlier CAR T-cell therapy use in first-line high-risk DLBCL is recommended, while use in second line is a standard-of-care treatment for some lymphoma subtypes.
  • CAR T-cell therapy is preferred to autologous stem cell transplant and complete response is no longer required.

Session slides

To download the slides presented, click here.

Download here

This activity was supported through an educational grant from Bristol Myers Squibb.

  1. Greinix HT, et al. Ensuring center quality, proper patient selection and fair access to chimeric antigen receptor T-cell therapy: position statement of the Austrian CAR-T Cell Network. Magazine of European Medical Oncology. 2020;13:27-31. DOI: 1007/s12254-020-00582-4.
  2. Rudzki CJ. First real world data from the Austrian CAR T Network. Poster #2964. EBMT-EHA 5th European CAR T-cell Meeting; Feb 9, 2023; Rotterdam, NL.

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