Michael Jain: 5-year outcomes of standard-of-care Axicabtagene Ciloleucel in lymphoma patients
Michael Jain, Oncologist at Moffitt Cancer Center, shared on X:
“What is important for long-term survivors after CAR T cell therapy? More and more patients are several years out from this amazing therapy.
How should we manage them? In our paper, we report on 5-year outcomes of standard-of-care lymphoma patients.
First, our “real world” outcomes of patients are nearly identical to the results of the ZUMA-1 clinical trial. Nearly 1/3 of patients are in remission (cured?) and 40% alive at 5 years.
We looked into causes of death. Still, lymphoma relapse is the biggest cause of death after CAR T cell therapy. But relapses were uncommon beyond 1 year. But non-relapse mortality (NRM) still occurred. Amazingly for all the work we do on CRS and ICANS, NRM in year 1 is not that much different than NRM in year 2 or year 3.
What causes NRM? Mainly infections and, to a lesser extent, second malignancies. And this continues to occur each year, for a 5 year NRM of 16%.
Importantly, age really matters. Patients below age 60 had very little NRM. But, while older patients have more NRM, they also have better lymphoma outcomes than younger patients, with decreased relapses! So older patients still benefit.
Overall our data shows what is important for long term survivorship after CAR T: we need to prevent relapse, prevent infections, learn more about secondary malignancies, and apply principles of geriatric oncology in order to improve patient outcomes.
This work was done by the 17 centers in the US lymphoma CAR T consortium, amazing data visualization by Jay Spiegel and conception by Saurabh Dahiya.”
Source: Michael Jain/X
Authors: Michael D. Jain, Jay Y. Spiegel, Loretta J. Nastoupil, John Tamaresis, Armin Ghobadi, Yi Lin, Lazaros Lekakis, Patrick Reagan, Olalekan Oluwole, Joseph McGuirk, Abhinav Deol, Kathleen A. Dorritie, Alison R. Sehgal, Andre Goy, Brian T. Hill, Charalambos Andreadis, Javier Munoz, Matthew Ulrickson, Jason Westin, Julio C. Chavez, Dilan Patel, Miriam T. Jacobs, Radhika Bansal, N. Nora Bennani, Vivek G. Patel, Aaron P. Rapoport, Julie M. Vose, David B. Miklos, Sattva S. Neelapu, Frederick L. Locke, Matthew Lunning, Saurabh Dahiya