Fludarabine- vs Bendamustine-Based Lymphodepletion Prior to CAR-T Therapy for Relapsed/Refractory DLBCL
Alaa Ali, MD, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, discusses findings from a real-world study that compared fludarabine- and bendamustine-based lymphodepletion prior to CAR-T therapy for the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL).
The study showed that patients receiving fludarabine-based lymphodepletion had a higher overall response rate but similar complete response without a significant impact on either progression-free or overall survival compared to those receiving bendamustine. However, bendamustine was associated with a reduced incidence of severe cytokine release syndrome, ICANS, and prolonged cytopenia.
Based on these findings, Dr Ali noted that although fludarabine-cyclophosphamide remains the standard of care for lymphodepletion prior to CAR-T therapy, bendamustine-based lymphodepletion is a viable option, especially for those patients at higher risk for treatment-related toxicities.
Dr Ali presented these findings at the 66th ASH Annual Meeting in San Diego, California.
Source:
Ali A, Ahmed N, Kim S, et al. Real World Comparison of Efficacy and Safety of Fludarabine-Versus Bendamustine-Based Lymphodepleting Chemotherapy for CD19 Chimeric Antigen Receptor (CAR) T-Cell Therapy in Relapse/Refractory (r/r) Large B-Cell Lymphoma (LBCL). Presented at the 66th ASH Annual Meeting & Exposition; December 7-10, 2024; San Diego, California. Abstract 71.
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