Dr. Oluwole on Long-Term Brexu-Cel Outcomes in ZUMA-3

At the 2024 American Society of Clinical Oncology Annual Meeting in Chicago, Illinois, Blood Cancers Today met with Olalekan Oluwole, MD, of the Vanderbilt University Medical Center, to hear data from the phase II ZUMA-3 trial on brexucabtagene autoleucel (brexu-cel) in patients with relapsed or refractory acute lymphoblastic leukemia.
“Some of the earlier presentations demonstrated the response rate and toxicity profile and how tolerable [brexu-cel] was in ZUMA-3,” Dr. Oluwole said. “This was an updated analysis of how patients were doing multiple years after the one-time therapy, and the interesting finding was that there was really no new toxicity.”
The 48-month analysis covered the 57 of 78 patients included in ZUMA-3 who responded.
“Of those 57, 14 patients had allogeneic stem cell transplant, and of those 14 patients, six had toxicity and are no longer alive, so there seems to be excess mortality in patients who had allogeneic transplant,” Dr. Oluwole said. He added that many patients who did not receive allogeneic transplantation were still alive and undergoing follow up.
“Overall, what we found is patients who had received blinatumomab before they received brexu-cel seemed to have less response rates and higher infection rates,” Dr. Oluwole stated. The analysis also showed that patients who had received one or more lines of therapy before brexu-cel had more infections and more adverse events,
Given those findings, the data suggest that “we really want to try to give CAR-T to patients earlier rather than later,” Dr. Oluwole summarized. “When we give it later, we have more complications and it doesn’t seem to work as well.”