Dr Epstein-Peterson on the Use of CAR T-Cell Therapy in MCL

Zachary Epstein-Peterson, MD, attending physician, Memorial Sloan Kettering Cancer Center, discusses the use of CAR T-cell therapy in mantle cell lymphoma (MCL) and highlights questions that remain to be answered within the treatment landscape.

Clinicians and patients alike are in a golden age of therapy for treating patients with MCL, Epstein-Peterson begins. However, historically, the outcomes for patients with the disease are very poor, specifically in patients with relapsed/refractory disease, Epstein-Peterson notes, adding that despite this, there are now many new tools in a treating clinician’s treatment armamentarium, most of which he says are effective and tolerable. Overall, it is a promising time to help care for patients with the disease and assist in pioneering new treatments for the future, Epstein-Peterson adds.

Looking to the future of beneficial treatments for this patient population, the landscape is likely to include CAR T-cell therapies, Epstein-Peterson continues. CAR T cells are firmly established in the care of patients with diffuse large B-cell lymphoma, but not as much in the care of patients with MCL, Epstein-Peterson adds. Based on the data seen from treatment with brexucabtagene autoleucel (brexu-cel; Tecartus) and lisocabtagene maraleucel (liso-cel; Breyanzi), these therapies work well in treating patients with MCL, though there are differing toxicity profiles between the 2 regimens. Despite the associated adverse events, the therapies remain manageable, Epstein-Peterson notes.

It remains vital to be aware of cytokine release syndrome and of neurotoxicity in patients, though this does not deter from the agents’ efficacy, Epstein-Peterson adds. Investigators will continue to investigate the optimal patient population to be treated with CAR T-cell therapies and how the CAR T-cell treatments can be best sequenced with one another in the relapsed/refractory setting, Epstein-Peterson explains. Ultimately, clinicians will need to address toxicities more effectively moving forward, but the data from CAR T-cell therapy to date in MCL are encouraging, Epstein-Peterson concludes.