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AXICABTAGENE CILOLEUCEL (AXI-CEL) IN PATIENTS WITH REFRACTORY LARGE B CELL LYMPHOMA: OUTCOMES BY PRIOR LINES OF THERAPY IN ZUMA-1
Author(s): ,
Frederick L. Locke
Affiliations:
Moffitt Cancer Center,Tampa,United States
,
Armin Ghobadi
Affiliations:
Washington University School of Medicine,St. Louis,United States
,
Lazaros J. Lekakis
Affiliations:
University of Miami Health System, Sylvester Comprehensive Care Center,Miami,United States
,
David B. Miklos
Affiliations:
Stanford University,Stanford,United States
,
Caron A. Jacobson
Affiliations:
Dana-Farber Cancer Institute,Boston,United States
,
Eric Jacobsen
Affiliations:
Dana-Farber Cancer Institute,Boston,United States
,
Ira Braunschweig
Affiliations:
Montefiore Medical Center, Albert Einstein College of Medicine,Bronx,United States
,
Olalekan O. Oluwole
Affiliations:
Vanderbilt-Ingram Cancer Center,Nashville,United States
,
Tanya Siddiqi
Affiliations:
City of Hope National Medical Center,Duarte,United States
,
Yi Lin
Affiliations:
Mayo Clinic,Rochester,United States
,
Patrick Reagan
Affiliations:
University of Rochester School of Medicine,Rochester,United States
,
Umar Farooq
Affiliations:
University of Iowa,Iowa City,United States
,
Abhinav Deol
Affiliations:
Karmanos Cancer Center, Wayne State University,Detroit,United States
,
Adrian Bot
Affiliations:
Kite, a Gilead company,Santa Monica,United States
,
John M. Rossi
Affiliations:
Kite, a Gilead company,Santa Monica,United States
,
Yizhou Jiang
Affiliations:
Kite, a Gilead company,Santa Monica,United States
,
Allen Xue
Affiliations:
Kite, a Gilead company ,Santa Monica,United States
,
William Y. Go
Affiliations:
Kite, a Gilead company,Santa Monica,United States
Sattva S. Neelapu
Affiliations:
The University of Texas MD Anderson Cancer Center,Houston,United States
(Abstract release date: 05/17/18) EHA Library. O. Oluwole O. 06/16/18; 214449; S801
Olalekan O. Oluwole
Olalekan O. Oluwole
Contributions
Abstract

Abstract: S801

Type: Oral Presentation

Presentation during EHA23: On Saturday, June 16, 2018 from 12:00 - 12:15

Location: Room A1

Background
In ZUMA-1 (NCT02348216), axi-cel, an anti-CD19 chimeric antigen receptor (CAR) T cell therapy, demonstrated significant benefit in patients with refractory large B cell lymphoma with an objective response rate (ORR) of 82% (complete response [CR] 58%; Neelapu & Locke et al. N Engl J Med. 2017). These results supported the recent approval of axi-cel by the US FDA for the treatment of adult patients with relapsed or refractory large B cell lymphoma after ≥ 2 prior lines of systemic therapy.

Aims
To assess outcomes of axi-cel by prior lines of therapy (LoT) in patients from Phases 1 and 2 of ZUMA-1.

Methods
All patients provided written informed consent. Patients with refractory large B cell lymphoma were leukapheresed and received 2 × 106 CAR T cells/kg after low-dose conditioning chemotherapy (Neelapu & Locke et al. N Engl J Med. 2017). Patients were evaluated by number of prior LoT: 2–3 vs ≥ 4. Autologous stem cell transplant (ASCT) was considered a prior LoT.

Results
 As of 8/11/17, median follow-up was 15.4 months for the 108 patients treated with axi-cel. Sixty-two (57%) patients had 2–3 prior LoT and 43 (40%) had ≥ 4. Patients with 2–3 and ≥ 4 prior LoT had median ages of 60 and 55 y, 65% and 47% of patients had ECOG performance status 1, 18% and 42% had prior ASCT, and 76% and 93% had disease stage III/IV, respectively. ORRs were 94% and 67% for patients with 2–3 and ≥ 4 prior LoT, respectively, with CR rates of 65% and 53%; 44% and 42% of patients had ongoing responses as of the data cutoff (Table). Overall survival (OS) at 12 months was 65% and 51% for patients with 2–3 and ≥ 4 prior LoT, respectively. Grade ≥ 3 treatment-emergent adverse events (AEs) were reported for nearly all (100% and 93%) patients with 2–3 and ≥ 4 LoT, with similar rates of Grade ≥ 3 cytokine release syndrome (11% and 12%) and neurologic events (32% and 30%). There were 1 and 3 Grade 5 AEs unrelated to disease progression in the 2–3 and ≥ 4 LoT groups, respectively.

Conclusion
Axi-cel demonstrated long-term clinical benefit for patients with refractory large B cell lymphoma, regardless of the number of prior LoT.

 

Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical

Keyword(s): Cancer immunotherapy, CD19, Non-Hodgkin's lymphoma

Abstract: S801

Type: Oral Presentation

Presentation during EHA23: On Saturday, June 16, 2018 from 12:00 - 12:15

Location: Room A1

Background
In ZUMA-1 (NCT02348216), axi-cel, an anti-CD19 chimeric antigen receptor (CAR) T cell therapy, demonstrated significant benefit in patients with refractory large B cell lymphoma with an objective response rate (ORR) of 82% (complete response [CR] 58%; Neelapu & Locke et al. N Engl J Med. 2017). These results supported the recent approval of axi-cel by the US FDA for the treatment of adult patients with relapsed or refractory large B cell lymphoma after ≥ 2 prior lines of systemic therapy.

Aims
To assess outcomes of axi-cel by prior lines of therapy (LoT) in patients from Phases 1 and 2 of ZUMA-1.

Methods
All patients provided written informed consent. Patients with refractory large B cell lymphoma were leukapheresed and received 2 × 106 CAR T cells/kg after low-dose conditioning chemotherapy (Neelapu & Locke et al. N Engl J Med. 2017). Patients were evaluated by number of prior LoT: 2–3 vs ≥ 4. Autologous stem cell transplant (ASCT) was considered a prior LoT.

Results
 As of 8/11/17, median follow-up was 15.4 months for the 108 patients treated with axi-cel. Sixty-two (57%) patients had 2–3 prior LoT and 43 (40%) had ≥ 4. Patients with 2–3 and ≥ 4 prior LoT had median ages of 60 and 55 y, 65% and 47% of patients had ECOG performance status 1, 18% and 42% had prior ASCT, and 76% and 93% had disease stage III/IV, respectively. ORRs were 94% and 67% for patients with 2–3 and ≥ 4 prior LoT, respectively, with CR rates of 65% and 53%; 44% and 42% of patients had ongoing responses as of the data cutoff (Table). Overall survival (OS) at 12 months was 65% and 51% for patients with 2–3 and ≥ 4 prior LoT, respectively. Grade ≥ 3 treatment-emergent adverse events (AEs) were reported for nearly all (100% and 93%) patients with 2–3 and ≥ 4 LoT, with similar rates of Grade ≥ 3 cytokine release syndrome (11% and 12%) and neurologic events (32% and 30%). There were 1 and 3 Grade 5 AEs unrelated to disease progression in the 2–3 and ≥ 4 LoT groups, respectively.

Conclusion
Axi-cel demonstrated long-term clinical benefit for patients with refractory large B cell lymphoma, regardless of the number of prior LoT.

 

Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical

Keyword(s): Cancer immunotherapy, CD19, Non-Hodgkin's lymphoma

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