VJHemOnc Podcast Sequencing therapies in R/R NHL: immunotherapy in DLBCL, BTKis in MCL, & more!
Apr 14, 2025
Paolo Strati, an Associate Professor at MD Anderson Cancer Center, and Gloria Iacoboni, a hematologist at Vall d’Hebron Hospital, delve into therapy sequencing for relapsed/refractory non-Hodgkin lymphoma. They discuss innovations in diffuse large B-cell lymphoma, emphasizing the impact of CAR T-cell and bispecific therapies. The pair also tackles timing for CD19 therapy post-bendamustine and explores the evolving landscape of mantle cell lymphoma treatments, highlighting the role of BTK inhibitors and the importance of personalized therapy approaches.
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Preference for CAR T Over Bispecifics
- CAR T-cell therapy is preferred first for third-line relapsed/refractory DLBCL due to its curative potential.
- Bispecific antibodies are used mainly after CAR T therapy as their long-term efficacy data is still maturing.
Use Bispecifics as CAR T Bridge
- Consider using bispecific antibodies as bridging therapy before CAR T to control disease during manufacturing.
- Adjust bispecific dosing schedules to accommodate patients with high tumor burden and rapidly progressing lymphoma.
Emerging Cellular Therapies in MCL
- Mantle cell lymphoma remains difficult to cure with current therapies, and mortality/morbidity from CAR T remains high.
- New cellular therapies like allogeneic NK cells and macrophage-based treatments offer promising antigen-agnostic alternatives.