Brexucabtagene Autoleucel vs Standard-Of-Care Treatment for Patients With R/R MCL

Comparative Analysis of the SCHOLAR-2 and ZUMA-2 Trials

According to findings from a comparative analysis of the SCHOLAR-2 and ZUMA-2 trials published in Leukemia & Lymphoma, brexucabtagene autoleucel (brexu-cel) showed significant survival benefits compared to the standard-of-care treatment among patients with relapsed/refractory (R/R) mantle cell lymphoma (MCL) after covalent BTK inhibitor exposure.

The SCHOLAR-2 trial assessed survival outcomes among patients with R/R MCL who received the standard-of-care treatment. The ZUMA-2 trial evaluated the efficacy of brexu-cel among patients with R/R MCL who had previously undergone Bruton’s tyrosine kinase (BTK) inhibitor therapy.

Georg Hess, MD, University Medical School of the Johannes Gutenberg-University, Mainz, Germany, and coauthors stated, “The SCHOLAR-2 retrospective study highlighted poor overall survival (OS) with standard of care (SOC) regimens among patients with relapsed/refractory (R/R) mantle cell lymphoma (MCL) who failed a covalent Bruton tyrosine kinase inhibitor.” 

“Brexucabtagene autoleucel demonstrated high rates of durable responses in patients with R/R MCL who had previous BTK [inhibitor] exposure” in the ZUMA-2 trial, they added. 

In order to assess the survival outcomes of brexu-cel versus the standard-of-care treatment for R/R MCL, Dr Hess et al performed a comparative analysis of the 2 studies. Overall survival was compared using inverse probability weighting (IPW), regression adjustment (RA), and doubly robust (DR), all of which adjusted for imbalances of prognostic factors between populations. Outcomes of this comparative analysis indicated that brexu-cel was associated with better overall survival compared to the standard-of-care treatment across both adjusted and unadjusted comparisons. 

Dr Hess and coauthors concluded, “the naïve and adjusted indirect comparisons suggested that brexu-cel was more effective in terms of OS than non-CAR T-cell SOC for the treatment of R/R MCL post-BTK [inhibitor] therapy.” 

“The consistency of the results across the naive and various adjustment methods and the high concordance across the various sensitivity analyses provide compelling evidence for the validity and robustness of the study findings,” they added. 

Source: 

Hess G, Dreyling M, Oberic L, et al. Indirect treatment comparison of brexucabtagene autoleucel (ZUMA-2) versus standard of care (SCHOLAR-2) in relapsed/refractory mantle cell lymphoma. Leuk & Lymph. Published online October 16, 2023. doi: 10.1080/10428194.2023.2268228