Five-Year Follow-Up Analysis of ZUMA-5: Axicabtagene Ciloleucel in Relapsed/Refractory Indolent Non-Hodgkin Lymphoma
Abstract
Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for relapsed/refractory (R/R) follicular lymphoma (FL). Here, we report updated clinical outcomes from ZUMA-5 in 159 enrolled patients with R/R indolent non-Hodgkin lymphoma (iNHL; 127 with FL and 31 with marginal zone lymphoma) after a median follow-up of 64.6 months. Patients underwent leukapheresis and received lymphodepleting chemotherapy and axi-cel (2 × 10 6 CAR T cells/kg). The overall response rate was 90% (75% complete response rate). The median duration of response was 60.4 months, and the median progression-free survival (PFS) was 62.2 months; median time to next treatment and overall survival were not reached (NR). At data cutoff, 55% of patients were alive without requiring subsequent anticancer therapy. Median lymphoma-specific PFS in patients with FL was NR; 34% had progression or death due to lymphoma or study treatment. Notably, after 30 months postinfusion, progression or lymphoma-related deaths were rare. Late-onset toxicities were infrequent and largely unrelated to axi-cel. Durable response and prolonged survival in FL were associated with robust early CAR T-cell expansion and naïve product phenotype. These findings confirm sustained responses and manageable safety with axi-cel in the long term among patients with R/R iNHL and its potential as a curative therapy in FL.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (23)
Sattva S. Neelapu
Julio C. Chavez
4Moffitt Cancer Center, Tampa, FL
Alison R. Sehgal
UPMC Hillman Cancer Center, Pittsburgh, PA
Narendranath Epperla
University of Utah, Salt Lake City, Utah, United States
Matthew L. Ulrickson
3Section of Hematology, Banner MD Anderson Cancer Center, Gilbert, AZ
Emmanuel Bachy
Pashna N. Munshi
Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
Carla Casulo
18Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
David G. Maloney
Fred Hutchinson Cancer Center, Seattle, Washington, United States
Sven de Vos
7Department of Medicine, Hematology/Oncology, Ronald Reagan University of California Los Angeles Medical Center, Los Angeles, CA
Ran Reshef
13Division of Hematology/Oncology, Blood and Marrow Transplantation and Cell Therapy Program, Columbia University Irving Medical Center, New York, NY
Lori A. Leslie
John Theurer Cancer Center, Hackensack, NJ
Olalekan O. Oluwole
Ibrahim Yakoub-Agha
9CHU de Lille, Univ Lille, INSERM U1286, Infinite, 59000 Lille, Lille, France
Rashmi Khanal
1Temple University Hospital, Philadelphia, United States
Joseph D. Rosenblatt
University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
Jacob Wulff
3Kite Pharmaceuticals, Santa Monica, United States
Rhine R. Shen
19Kite, a Gilead company, Santa Monica, CA
Wangshu Zhang
19Kite, a Gilead company, Santa Monica, CA
Soumya Poddar
Kite, a Gilead Company, Santa Monica, California, United States
Harry Miao
Kite, a Gilead Company, Santa Monica, CA
Olga Nikolajeva
6Kite, a Gilead Company, Santa Monica, United States
Caron A. Jacobson
5Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA