MRD Assessment May Refine Prognosis After CAR-T for Follicular Lymphoma

A study presented at the American Society of Clinical Oncology (ASCO) annual meeting suggested that circulating tumor (ct)DNA-based measurable residual disease (MRD) assessment may provide prognostic information for patients with relapsed or refractory follicular lymphoma treated with lisocabtagene maraleucel (liso-cel; Breyanzi).

In this MedPage Today video, Yazeed Sawalha, MD, of the Ohio State University Wexner Medical Center in Columbus, discusses the findings.

Following is a transcript of his remarks:

The study was presented by Dr. Ariel Avilion from BMS [Bristol Myers Squibb] and investigated using circulating tumor DNA to measure minimal residual disease using the CLARITY assay in patients with follicular lymphoma treated with liso-cel in the TRANSCEND trial.

Liso-cel achieved deep responses, with 89% of patients achieving undetectable MRD. And then for those who achieved a complete response by PET, 93% also achieved undetectable MRD.

Achieving undetectable MRD was a powerful predictor of long-term outcomes. At 3 years, the PFS [progression-free survival] was 80% for patients with undetectable MRD compared to only 38% of patients with detectable MRD.

The study also found that MRD provides better prognostic information than PET scans alone for patients who were PET-negative but were still MRD-detectable at 3 months. Their outcomes were worse, with a 3-year PFS of only 56% compared to a 3-year PFS of 81% for patients with negative PET scans and undetectable MRD.

So, the main takeaway from the study is the high efficacy of T cell-based therapies, CAR [chimeric antigen receptor] T-cells, which can lead to deep and durable responses in relapsed or refractory follicular lymphoma.