Zamtocabtagene autoleucel, a tandem CD20-CD19-directed CAR T-cell therapy, for second line treatment of large B-cell lymphoma in patients ineligible for transplantation (DALY 2-EU): primary analysis of an open-label, multicentre, randomised phase 2 study.

What was studied

This trial compared a CAR T-cell therapy, zamto-cel, with chemotherapy for large B-cell lymphoma. The cancer had returned or had not responded. Patients could not have a transplant. It was an open-label phase 2 trial at 45 centres in 12 countries in Europe. 160 patients were randomly assigned, 82 to zamto-cel and 78 to R-GemOx chemotherapy.

What they found

Event-free survival was longer with zamto-cel than with R-GemOx. Serious adverse events occurred in 31 patients with zamto-cel and 50 with R-GemOx. Grade 3 or higher events were frequent in both groups. They occurred in 63 of 76 patients with zamto-cel and 65 of 76 with R-GemOx. Treatment-related deaths occurred in both groups.

What it means for patients

The authors point to the balance of risk and benefit seen in the trial. They say it supports considering zamto-cel as a standard second-line option. This is for people who cannot have a transplant.

Why it is not certain yet

It was an open-label trial. It was a phase 2 trial with 160 patients. The trial is still ongoing. Serious side effects and treatment-related deaths did occur with zamto-cel.

Source

Zamtocabtagene autoleucel, a tandem CD20-CD19-directed CAR T-cell therapy, for second line treatment of large B-cell lymphoma in patients ineligible for transplantation (DALY 2-EU): primary analysis of an open-label, multicentre, randomised phase 2 study.

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