How do you see tandem CAR T-cell therapies fitting into the future treatment landscape for LBCL?

The Lymphoma Hub was pleased to speak with Ulrich Jäger, Medical University of Vienna, AT. We asked, How do you see tandem CAR T-cell therapies fitting into the future treatment landscape for LBCL?

In this interview, Jäger discusses the potential role of CD19/CD20-targeted chimeric antigen receptor (CAR) T-cell therapies in relapsed/refractory (R/R) large B-cell lymphoma (LBCL). He explores the rationale for targeting both CD19 and CD20, highlights clinical data with zamtocabtagene autoleucel (zamto-cel), and considers how tandem CAR T-cell therapies may address unmet needs in R/R LBCL and fit into the evolving treatment landscape. 

Key points

• CD19-directed CAR T-cell therapies have substantially improved outcomes for patients with R/R LBCL; however, relapse after CAR T-cell therapy remains an important challenge, highlighting the need for strategies that can further improve the durability of response.¹
• Tandem CD19/CD20 CAR T-cell therapies have the potential to reduce the risk of relapse associated with loss or downregulation of either target antigen.^1,2
• Results from the phase II DALY 2-EU trial (NCT04844866) showed that zamto-cel, a tandem CD19/CD20 CAR T-cell therapy, improved event-free survival and progression-free survival vs rituximab + gemcitabine + oxaliplatin (R-GemOx) in second-line, transplant-ineligible patients with R/R LBCL.² 
• Favorable early results from other studies assessing CD19/CD20 CAR T-cell therapies further support the potential of dual-antigen targeting as an emerging therapeutic approach.^3,4
• While the efficacy of tandem CD19/CD20 CAR T-cell therapies appears to be comparable to CD19 CAR T-cell therapies, whether dual targeting CD19 and CD20 can reduce the risk of late relapses associated with downmodulation of one of the two antigens remains to be established, with more data from longer follow-up needed.¹
• Given that tandem CD19/CD20 CAR T-cell therapies have shown promising efficacy with favorable safety profiles,² Jäger anticipates their adoption into routine clinical practice, with regulatory approvals expected in the near future. 

This educational resource is independently supported by Miltenyi Biomedicine. All content is developed by SES in collaboration with an expert steering committee. Funders are allowed no influence.