Dr Gordon on Next Steps for Optimizing Liso-Cel Use in R/R MCL

Leo I. Gordon, MD, Abby and John Friend Professor of Oncology Research, professor, medicine (hematology and oncology), Feinberg School of Medicine, Robert H. Lurie Cancer Center, discusses findings from the mantle cell lymphoma (MCL) cohort of the phase 1 TRANSCEND NHL 001 trial (NCT02631044), highlighting next steps for optimizing the use of lisocabtagene maraleucel (liso-cel; Breyanzi) in patients with relapsed/refractory MCL.

In the MCL cohort of TRANSCEND NHL 001, 85.3% (95% CI, 74.6%-92.7%) of patients treated with liso-cel achieved a response, including a complete response rate of 67.6% (95% CI, 55.2%-78.5%) and a partial response rate of 12.2%, Gordon begins. Additionally, 6.8% of patients experienced stable disease. Long-term remissions appear to occur in approximately 40% to 50% of patients, with most relapses happening within the first 6 months to a year after treatment, he reports. Gordon adds that some patients experience relapse after 2 years, but these cases are relatively rare.

Findings from the MCL cohort of the study supported the FDA approval of the CAR T-cell therapy liso-cel in relapsed/refractory MCL in May 2024.

There is hope that patients who remain in remission for 2 years or more may be cured, as several patients treated as far back as 2016 or 2017 are still in remission and leading healthy lives, Gordon continues. Many of these patients had undergone multiple prior treatments, including bone marrow transplants, highlighting the potential of liso-cel as a valuable treatment option for heavily pretreated patients, he says.

The significance of this advancement lies not only in its potential to offer durable remissions but also in its implications for future research, Gordon emphasizes. The next steps include exploring the use of liso-cel earlier in the treatment of high-risk MCL and investigating how to improve the construct by either enhancing its efficacy or combining it with other agents, he states. The recent approval of liso-cel for MCL marks a major milestone in the field, especially in an era where research funding has been challenging to secure, Gordon notes.

The approval comes at a critical time, underscoring the importance of continued basic research to drive innovation in oncology, Gordon states. As researchers and clinicians work to refine and expand the use of CAR T-cell therapies like liso-cel, the hope is to further improve outcomes for patients with MCL and other aggressive lymphomas, he concludes.