How do you incorporate CAR-T cell therapy for DLBCL in transplant-eligible patients?

The role of sequential therapy including CARs vs high dose chemotherapy + ASCT post primary induction failure/relapse in large cell lymphoma is a matter of active research. Given the present FDA indication of CARs is in relapsed/refractory large cell lymphoma after failure of at least 2 lines of pri...

We are treating medically eligible patients with DLBCL that is primary refractory or relapsed within 1 year of initial therapy with CAR T-cell therapy. If patients do not fit these criteria, we recommend proceeding to salvage chemotherapy and if chemo-sensitive, perform autologous stem cell transpla...

We are now recommending CAR-T for all medically-fit DLBCL patients with primary refractory disease (i.e. those with progressive or persistent FDG-avid lesions at the conclusion of frontline therapy). For those patients who achieve a complete remission but subsequently relapse, "salvage" or second-li...

For those patients with primary refractory disease (biopsy confirmed persistent disease or progression at the end of front line therapy) who are medically eligible, we are recommending CAR T cell therapy. Patients who had progression within 6 months of completing treatment are discussed, but given t...

A critical point when considering CAR T-cell therapy for patients with relapsed or refractory DLBCL is that transplant eligibility is not the same thing as CAR T eligibility. Many patients who might not be able to tolerate an autologous stem cell transplant would still be perfect candidates for CAR ...

For a transplant-eligible patient with a first relapse of DLBCL, how do you decide between the use of CAR-T vs transplant?

The short answer is: there is no one-size-fits-all approach, and guidance regarding optimal sequencing of subsequent therapies remains an unmet need. Providing individualized tre...