Weekly Spotlight - 03.10.24

In the News

Recognising Lymphoma: Symptoms from Survivors

In a groundbreaking study published in Blood Advances, CAR-T therapy has been shown to be both safe and effective when administered on an outpatient basis in community hospitals. This is particularly good news for patients with relapsed or refractory large B-cell lymphoma (LBCL), who often face logistical challenges in accessing this treatment. The study, led by Dr. Yuliya Linhares of the Miami Cancer Institute, involved 82 patients and demonstrated that 80% experienced a significant reduction in cancer, with 54% achieving complete remission.

Interestingly, the study found that outpatient treatment did not increase the risk of serious side effects, such as cytokine release syndrome or neurotoxicity. In fact, a quarter of the outpatient participants never required hospitalisation. Dr. Linhares expressed optimism that these findings could broaden access to CAR-T therapy, making it more feasible for patients to receive this life-saving treatment closer to home. The study's success underscores the importance of coordinated care and could pave the way for more community hospitals to offer this advanced therapy.

CAR-T Cell Therapy: A New Hope for Lymphoma Patients

CAR-T cell therapy, a beacon of hope in the realm of oncology, is revolutionising the treatment of lymphomas. Dr. Madiha Iqbal from the Mayo Clinic elucidates that this personalised therapy involves collecting a patient's T cells, genetically engineering them to target lymphoma, and reintroducing them post low-dose chemotherapy. This innovative approach has significantly improved survival rates for patients who previously had limited options, transforming a grim prognosis into a potential cure.

Before CAR-T cell therapy, patients unresponsive to multiple chemotherapy lines faced a bleak six-month survival outlook. Now, these modified T cells, akin to microscopic superheroes, can effectively combat and destroy lymphoma cells. This advancement underscores the remarkable strides in cancer treatment, offering renewed hope and optimism for patients worldwide.

Best Practices for Mantle Cell Lymphoma Treatment

Recent research into mantle cell lymphoma (MCL) has highlighted promising frontline therapies, though challenges remain for relapsed/refractory cases. For older patients, a regimen of bendamustine and rituximab shows a median progression-free survival of about four years. Younger, fitter patients benefit from intensive chemoimmunotherapy followed by stem cell transplants, with a median progression-free survival of 8.5 years. Second-generation Bruton tyrosine kinase inhibitors are emerging as potent alternatives, despite the rocky road paved by their predecessors.

In the relapsed/refractory setting, the outlook is less rosy. Patients progressing on Bruton tyrosine kinase inhibitors face dismal outcomes, and while CAR T-cell therapy offers hope, it comes with severe toxicity. However, early data on molecular glues, novel inhibitors, and bispecific antibodies provide a glimmer of optimism. As Dr. Patel quipped, "Why not just give everybody CAR T-cells?"—a playful nod to the ongoing quest for better treatments.

Sequencing Therapies in Relapsed/Refractory Mantle Cell Lymphoma: Insights and Challenges

Dr Craig A. Portell, an associate professor at the University of Virginia, is set to present on sequencing therapies in relapsed/refractory mantle cell lymphoma at the 2024 Society of Hematologic Oncology Annual Meeting. His session will delve into the complexities of managing patients post-Bruton's tyrosine kinase (BTK) inhibitor exposure, exploring the integration of CAR T-cell therapy and non-covalent BTK inhibitors. Portell is optimistic about the potential of bispecific antibodies, covalent BTK inhibitors, and venetoclax to address these challenges, though sequencing remains a puzzle.

Portell's presentation promises to be a treasure trove of insights, particularly for those grappling with p53-mutated relapse scenarios. He aims to provide a roadmap for clinicians, detailing pathways for patient relapse and progression management. With a touch of humour, he anticipates the lymphoma sessions will be both enlightening and thoughtfully reviewed, offering valuable suggestions for managing complex cases.

Advancements in B-Cell Lymphoma Treatments: Current and Future Prospects

The B-cell lymphoma treatment market is experiencing significant growth, driven by advancements in medical technology and an increasing incidence of the disease. Traditional therapies like chemotherapy and radiation are now complemented by cutting-edge treatments such as CAR-T cell therapy and targeted therapies, which offer more precise and effective options. The market, valued at USD 6,360.75 million in 2022, is projected to reach USD 13,145.36 million by 2030, with a CAGR of 8.4%. Diffuse Large B-Cell Lymphoma (DLBCL) remains the dominant subtype due to its high prevalence.

Several trends are shaping the market, including the rise of personalised treatments and combination therapies, which improve patient outcomes and reduce side effects. The growing focus on research and development is leading to innovative treatments, enhancing survival rates and quality of life for patients. Additionally, the Asia-Pacific region is emerging as a key growth area, driven by economic growth, increased healthcare expenditure, and heightened cancer awareness. The market's expansion is further supported by regulatory bodies expediting the approval of breakthrough therapies, making advanced treatments more accessible.

 CAR-T Therapy Safe and Effective in Community Outpatient Settings

In a groundbreaking study published in Blood Advances, CAR-T therapy has been shown to be both safe and effective when administered on an outpatient basis in community hospitals. This is particularly good news for patients with relapsed or refractory large B-cell lymphoma (LBCL), who often face logistical challenges in accessing this treatment. The study, led by Dr. Yuliya Linhares of the Miami Cancer Institute, involved 82 patients and demonstrated that 80% experienced a significant reduction in cancer, with 54% achieving complete remission.

Interestingly, the study found that outpatient treatment did not increase the risk of serious side effects, such as cytokine release syndrome or neurotoxicity. In fact, a quarter of the outpatient participants never required hospitalisation. Dr. Linhares expressed optimism that these findings could broaden access to CAR-T therapy, making it more feasible for patients to receive this life-saving treatment closer to home. The study's success underscores the importance of coordinated care and could pave the way for more community hospitals to offer this advanced therapy.