How do you incorporate CAR-T cell therapy in the second-line setting for DLBCL in transplant-eligible patients?
How do you assess chemosensitive vs chemorefractory disease?
Given the results of ZUMA-7, TRANSFORM, and BELINDA - will you be altering your current practice?
Answer from: Medical Oncologist at Academic Institution
The role of sequential therapy including CARs vs high dose chemotherapy + ASCT post primary induction failure/relapse in large cell lymphoma is a matter of active research. Given the present FDA indication of CARs is in relapsed/refractory large cell lymphoma after failure of at least 2 lines of pri...
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Answer from: Medical Oncologist at Academic Institution
We are treating medically eligible patients with DLBCL that is primary refractory or relapsed within 1 year of initial therapy with CAR T-cell therapy. If patients do not fit these criteria, we recommend proceeding to salvage chemotherapy and if chemo-sensitive, perform autologous stem cell transpla...
Answer from: Medical Oncologist at Academic Institution
We are now recommending CAR-T for all medically-fit DLBCL patients with primary refractory disease (i.e. those with progressive or persistent FDG-avid lesions at the conclusion of frontline therapy). For those patients who achieve a complete remission but subsequently relapse, "salvage" or second-li...
Answer from: Medical Oncologist at Academic Institution
For those patients with primary refractory disease (biopsy confirmed persistent disease or progression at the end of front line therapy) who are medically eligible, we are recommending CAR T cell therapy. Patients who had progression within 6 months of completing treatment are discussed, but given t...