Factors That Can Influence How Well CAR T-Cell Therapy Works for MCL

Dr. Manali Kamdar, from the University of Colorado Cancer Center, analyzed if the number of prior treatments you’ve received and whether you were relapsed/refractory to BTK inhibitors influences how mantle cell lymphoma (MCL) patients respond to the CAR T-cell therapy liso-cel (Breyanzi, by BMS). 

Liso-cel was recently FDA-approved in May 2024 for relapsed/refractory MCL patients who had received at least two prior lines of therapy, including a BTK inhibitor. Click here to read more about its approval. 

Watch Dr. Kamdar’s interview below or read the summary of her findings to learn answers to key questions.  

How Effective is Liso-cel for MCL Based on Your Prior Lines of Therapy? 

Dr. Kamdar evaluated how well liso-cel worked for MCL patients based on the number of prior lines of treatments they had received.  

A line of treatment refers to the order in which you received different therapies (first, second, third, etc). The treatment groups evaluated were 2 lines, 3-4 lines, and 5-11 lines. 

73% of all patients experienced a full reduction of MCL signs/symptoms (complete remission) after receiving the single liso-cel infusion. 

Dr. Kamdar noticed that patients who received more than five prior lines of treatment had a lower complete remission rate of 65% and a shorter time in remission compared to MCL patients who had less than five prior lines of treatment. 

How Did MCL Patients Who Were Relapsed/Refractory to BTK Inhibitors Respond to Liso-cel?

MCL patients who were refractory to a BTK inhibitor had a lower response rate and a shorter time in remission when treated with liso-cel compared to patients who only relapsed after a BTK inhibitor but were not refractory. 

Refractory refers to cancer cells that either did not respond to treatment or became intolerant to it. Relapsed means that the BTK inhibitor was initially effective against the cancer, but the cancer progressed after treatment was discontinued.

Another thing noted by Dr. Kamdar was that patients who had 5 or more lines of treatment had a higher chance of becoming refractory or a BTK inhibitor. 

Conclusion

Based on these findings, Dr. Kamdar suggests it is better for MCL patients to receive the CAR T-cell therapy liso-cel before 5 lines of prior therapy. This can help improve their chances of complete remission and extend the time they remain in remission. Dr. Kamdar also found that patients who have become refractory to a BTK inhibitor have a lower response rate to liso-cel treatment than patients who have only relapsed after a BTK inhibitor. These insights can help you as you make treatment decisions with your doctor for mantle cell lymphoma. 

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Source: 

• SUBGROUP ANALYSES IN PATIENTS WITH R/R MCL TREATED WITH LISOCABTAGENE MARALEUCEL BY PRIOR LINES OF THERAPY AND RESPONSE TO BRUTON TYROSINE KINASE INHIBITOR FROM THE TRANSCEND NHL 001 MCL COHORT