CAR T-Cell Therapy vs Other Novel Therapies for Elderly Patients With Relapsed DLBCL

At the 2024 Great Debates & Updates (GDU) in Hematalogic Malignancies meeting in Los Angeles, California, Elizabeth Brem, MD, University of California, Irvine, discusses the role of CAR T-cell therapies versus other novel therapies for the treatment of older patients with relapsed diffuse large B-cell lymphoma (DLBCL), including polatuzumab, tafasitamab, lenalidomide, and loncastuximab.

“I think the fact that we even get to have this debate about which therapy and what order to use them is just a huge win compared to where we were just a few years ago,” noted Dr Brem.

Transcript:

My name is Liz Brem, associate clinical professor at the University of California, Irvine. I'm here at the Great Debates and Updates in Hematologic Malignancies [2024] in Los Angeles. One topic I had to debate today was about the role of [chimeric antigen receptor] CAR-T versus other novel therapies for our older patients with relapsed [diffuse large B-cell lymphoma] DLBCL.

This was kind of a fun one to do, but I think at the end of the day, Dr. [Mazyar] Shadman and I feel very similarly about this, which is the right patient really is a candidate for CAR T-cell. Age is not the only thing, and maybe shouldn't even be one of the primary things you put into this. For the right patient, for the right [case], it probably does make sense to go there.

But there's a lot of patients who can't, don't want to, and really aren't appropriate for CAR T-cell. This kind of gave me an opportunity to focus on those other choices. We talked a lot about the role of bispecific antibodies—whether or not we should give those with or without chemotherapy, time will tell. We talked a little bit about some of the other therapies available in this space, such as polatuzumab, tafasitamab, lenalidomide, and loncastuximab.

I think my take home whenever I think about this is, just a few years ago, if I had a 78 [or] 80-year-old patient with diffuse large B-cell lymphoma that came back, my toolkit was really limited. I think the fact that we even get to have this debate about which therapy and what order to use them is just a huge win compared to where we were just a few years ago.

Source:

Brem E. Should Older Patients with Relapsed DLBCL Receive Novel Agents? Presented at the Great Debates and Updates Meeting. July 27-28, Los Angeles, California.