CAR T-cell therapy demonstrates superior outcomes for patients with transformed follicular lymphoma (tFL) compared to those with newly diagnosed diffuse large B-cell lymphoma (DLBCL), according to research presented at the 66th annual meeting of the American Society of Hematology (ASH). The retrospective study, encompassing 691 patients across 14 U.S. centers from 2015 to 2024, found significantly improved three-year overall survival and progression-free survival in tFL patients receiving CAR T-cell therapy targeting CD19.
CAR T-Cell Therapy in Transformed Follicular Lymphoma
The study, led by Matthew Cortese, MD, MPH, Assistant Professor of Oncology at Roswell Park, addressed a critical gap in understanding the efficacy of CAR T-cell therapy in tFL patients. Previous clinical trials had merged data from tFL and DLBCL patients, obscuring the specific outcomes in the tFL subgroup. The new analysis provides a clearer picture, demonstrating that CAR T-cell therapy not only offers a survival advantage but also appears to mitigate the adverse prognosis associated with "double-hit" tFL, a particularly aggressive variant.
"Our large multi-center study has revealed that cellular therapy results in demonstrably better outcomes for patients with transformed follicular lymphoma compared with patients with DLBCL," said Dr. Cortese. He further emphasized the need to investigate the underlying reasons for this difference and to leverage these insights for developing more effective treatments.
Pembrolizumab in Hodgkin Lymphoma with Slow Early Response
In another study presented at ASH, Kara Kelly, MD, Chair of Roswell Park Oishei Children’s Cancer and Blood Disorders Program, highlighted the potential of pembrolizumab-based consolidation therapy for children, adolescents, and young adults with low-risk classic Hodgkin lymphoma (cHL) who exhibit a slow early response to initial chemotherapy. The KEYNOTE-667 trial (NCT03507144) evaluated a combination therapy of pembrolizumab, AVD (doxorubicin, vinblastine, and dacarbazine), and radiotherapy in selected patients during the consolidation phase.
The study enrolled 78 patients with low-risk cHL, with 10 identified as having a slow early response. After a median follow-up of 19.9 months, all 10 patients responded to the treatment, including five achieving a complete response. The investigators concluded that the approach demonstrated promising anti-tumor activity and manageable safety, warranting further investigation as a treatment option for this patient population.
"The inclusion of the immunotherapy agent pembrolizumab with standard chemotherapy and reduced doses of radiation therapy may help limit the acute and long-term toxicities while reducing relapse risk — especially important goals in young patients with Hodgkin lymphoma," Dr. Kelly noted, underscoring the potential for this approach to improve outcomes while minimizing treatment-related complications.
