Caron Jacobson, MD

Caron Jacobson, MD, shared some comments on ZUMA-7 with The ASCO Post. She called ZUMA-7 “an extremely important study to advance the care of high-risk early relapsing or primary refractory large B-cell lymphoma after front-line chemoimmunotherapy.” Dr. Jacobson is Assistant Professor of Medicine at Harvard Medical School and Medical Director of the Immune Engineered Cell Therapy Program at Dana-Farber Cancer Institute, Boston.

“For the past 30 years, salvage chemotherapy and autologous stem cell transplantation was the standard of care for these patients, but just 25% to 30% of them benefited. ZUMA-7 demonstrated that these patients have improved rates of durable response with the anti-CD19 CAR [chimeric] T-cell therapy axicabtagene ciloleucel in the second line, thus allowing us to avoid unnecessary and ineffective chemotherapy and go straight to the best treatment,” Dr. Jacobson said.

“Despite ZUMA-7 being a positive study with respect to its primary endpoint of event-free survival, people have previously argued that since axicabtagene ciloleucel is available in the third line, no harm would be done in waiting to give patients this therapy after an attempt at second-line chemotherapy. The significance of this update to ZUMA-7, then, is that we learned that even though 57% of patients experienced disease progression with the standard of care and received CAR T cells in the third line, there was still a survival benefit seen for the patients who received axicabtagene ciloleucel in the second line. This means that survival is negatively impacted by waiting to give CAR T cells in the third line for these high-risk patients and lends strong, unequivocal support to treating these patients with CAR T cells in the second-line setting,” she maintained.

The ongoing randomized ZUMA-23 study will investigate axicabtagene ciloleucel vs standard-of-care front-line chemoimmunotherapy in high-risk, newly diagnosed patients with large B-cell lymphoma. Positive results from this study would further advance the care of this population earlier in the disease course, she added. 

DISCLOSURE: Dr. Jacobson reported financial relationships with AbbVie, Abintus Bio, ADC Therapeutics, AstraZeneca, Bristol Myers Squibb, Caribou Biosciences, Celgene, Daiichi Sankyo/UCB Japan, Impact-Bio, Instil Bio, Ipsen, Kite/Gilead, Miltenyi Biomedicine, MorphoSys, Novartis, and Synthekine.