At the 2024 Lymphoma, Leukemia & Myeloma (LL&M) Congress in New York, New York, Craig Sauter, MD, Cleveland Clinic, Cleveland, Ohio, discusses the role of chimeric antigen receptor (CAR) modified T-cell therapy for patients with relapsed/refractory (R/R) aggressive lymphomas, including transformed chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) and diffuse large B-cell lymphoma (DLBCL).

Transcript:

I'm Craig Sauter. I'm the Director of Blood Marrow Transplant Program in Cellular Therapy at Cleveland Clinic, Ohio. [I’m] happy to be here at LL&M 2024 and today I'll be speaking about the positioning chimeric antigen receptor (CAR) modified T-cells for relapsed and refractory aggressive lymphomas, most predominantly large B-cell lymphoma and subtypes.

The talk will focus on the new indications for commercially available CAR-modified T-cells, as well as other potential interventions to enhance the efficacy of CAR T-cells, particularly in the second and later lines of therapy. [I] will also speak of positioning novel agents such as bispecific, T-cell engager antibodies with standard salvage chemotherapy that we've used in the past and how that fits in the treatment landscape along with CAR-modified T-cell largely for DLBCL.

I'll also be touching on some data in a difficult to treat clinical scenario of transformed chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL) or Richter’s transformation, as well as the role of CAR-modified T-cells in patients that are what we would consider transplant-eligible, typically older, more comorbid patients, and the role of the commercially available products in that setting.

The talk will largely conclude with some provocative questions of how we now sequence these novel therapies, and whether we readdress clinical trial designs around the positioning of bispecific T-cell engager antibodies, as well as CAR-modified T-cells in the contemporary treatment landscape.

There was a presentation from many academic centers looking at CAR-modified T-cells for Richter's transformed CLL/SLL. Historically, that has not been included on the commercial labels. We would argue that it has not been excluded either.

Some information came from a 12-center consortium that was presented at [the] American Society of Hematology (ASH) [meeting] last year and recently it has been published in the Journal of Clinical Oncology in 2024, providing some insight to how this modality can fit in the treatment landscape for that difficult to treat subtype of large cell lymphoma.

Source:

Sauter C. Where Do CAR-T Cells Fit in the Treatment of Aggressive Lymphoma? Presented at Lymphoma, Leukemia & Myeloma Congress; October 16-19, 2024. New York, NY.