A study was recently conducted of commercial lisocabtagene maraleucel (liso-cel) use in a cohort of real-world patients with Richter transformation (RT). With the largest of such study cohorts to date, its findings were presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting and published in the Journal of Clinical Oncology.
According to lead study author Allison Winter, MD, of Cleveland Clinic Taussig Cancer Institute, Ohio, the results “show that liso-cel provided meaningful clinical benefit with low incidences of grade 3 or higher [cytokine release syndrome (CRS)] and [immune effector cell-associated neurotoxicity syndrome (ICANS)] observed.”
The cohort comprised 30 patients in the United States from the Center for International Blood and Marrow Transplant Research. The median time from leukapheresis to liso-cel infusion in the cohort was 35 days, and it had a median follow-up of 12.3 months.
In 29 evaluable patients, the objective response rate was 76%, and 66% of patients achieved complete response. These patients had a median time to first response of 1.1 months. The median duration of response (DOR) was not reached, and the 12-month DOR rate was 77%. In 29 evaluable patients, the median progression-free survival (PFS) was not reached and the estimated PFS at 12 months was 54%. In 30 evaluable patients, the median overall survival (OS) was not reached and the OS at 12 months was 67%.
“The high complete response rate is promising in this difficult-to-treat population, and longer follow-up in a larger cohort is needed,” Dr. Winter wrote.
Regarding safety results, CRS affected 70% of the patients, where none had grade 3 CRS, 3% had grade 4, and 3% had grade 5. ICANS occurred in 47% of patients, where 17% had grade 3 ICANS, 10% had grade 4, and none had grade 5. Prolonged cytopenia occurred in 17% of the cohort and there was one patient in whom a second primary malignancy developed. In the total cohort there were eight mortalities, seven of which were due to progression.
Reference
Winter AM, Bharadwaj S, Herrera AF, et al. Real-world outcomes of lisocabtagene maraleucel (liso-cel) in patients (pt) with Richter transformation (RT) from the Center for International Blood and Marrow Transplant Research (CIBMTR). Abstract #7010. Presented at the 2024 ASCO® Annual Meeting; May 31-June 4, 2024; Chicago, Illinois.