On March 8, 2023 JW Therapeutics (HKEX: 2126), an independent and innovative biotechnology company focusing on developing, manufacturing and commercializing cell immunotherapy products, reported the initiation of clinical study of Carteyva (relmacabtagene autoleucel injection) for first-line treatment in patients with high-risk large B-cell lymphoma and the first patient infusion (Press release, JW Therapeutics, MAR 8, 2023, View Source [SID1234628362]).
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High-risk large B-cell lymphoma includes large B-cell lymphoma with International Prognostic Index (IPI) score ≥3, and high-grade B-cell lymphoma (HGBL) with MYC and BCL2 and/or BCL6 translocations (double-/triple-hit lymphomas; DHL/THL). Patients with high-risk large B-cell lymphoma (IPI≥3) have a low response to standard first-line chemotherapy, with complete response rate (CRR) 47.3%, 3-year overall survival (OS) rate 58.9% and progression-free survival (PFS) rate 40.7%. HGBL patients with MYC and BCL2 and/or BCL6 translocations (DHL/THL) tend to have poor prognostic indicators (e.g. bone marrow involvement, central nervous system (CNS) involvement, and elevated lactate dehydrogenase) and no recommended standard first-line therapies, with poor efficacy (CRR 59.6%) to traditional standard first-line R-CHOP chemotherapy. CRR of these patients remains <60% when treated with DA-EPOCH-R therapy and there is no significant survival benefit with the more aggressive induction regimen compared with standard R-CHOP. Therefore, there are substantial unmet clinical needs in the first-line treatment of high-risk large B-cell lymphoma patients, and new treatment options are urgently needed.
In its pivotal clinical study (RELIANCE study), Carteyva has demonstrated manageable safety profiles and high efficacy in patients with relapsed/refractory large B-cell lymphoma who have received at least two lines of therapies. The encouraging results have inspired CAR-T therapy destined for earlier lines of therapies in high-risk large B-cell lymphoma.
The study is an open-label, single-arm, multicenter, and investigator-initiated trial (IIT) in China, aiming to evaluate the efficacy and safety of Carteyva as first-line therapy in adult subjects with high-risk large B-cell lymphoma.
References
McMillan, A. K., et al. Favorable outcomes for high-risk diffuse large B-cell lymphoma (IPI 3-5) treated with front-line R-CODOX-M/R-IVAC chemotherapy: results of a phase 2 UK NCRI trial. Ann Oncol, 31(9), 1251-1259 (2020).
Ying Zhao, et al. Prognostic analysis of DLBCL patients and the role of upfront ASCT in high-intermediate and high-risk patients. Oncotarget, 8(42), 73168-73176 (2017).
China Anti-cancer Association Lymphoma Committee, et al. Clinical practice guideline for lymphoma in China (2021 Edition). Chin J Oncol, 43(7), 707-735 (2021).
Bartlett, N. L. et al. Dose-adjusted EPOCH-R compared with R-CHOP as frontline therapy for diffuse large B-cell lymphoma: clinical outcomes of the phase III Intergroup Trial Alliance/CALGB 50303. J. Clin. Oncol. 37,1790–1799 (2019).
Ying Z, et al. Relmacabtagene autoleucel (relma-cel) CD19 CAR-T therapy for adults with heavily pretreated relapsed/refractory large B-cell lymphoma in China. Cancer Med. 10(3):999-1011 (2021).
About Relmacabtagene Autoleucel Injection (trade name: Carteyva)
Relmacabtagene autoleucel injection (abbreviated as relma-cel, trade name: Carteyva) is an autologous anti-CD19 CAR-T cell immunotherapy product independently developed by JW Therapeutics based on a CAR-T cell process platform of Juno Therapeutics (a Bristol Myers Squibb company). Being the first product of JW Therapeutics, relma-cel has been approved by the China National Medical Products Administration (NMPA) for two indications, including the treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, and the treatment of adult patients with follicular lymphoma that is refractory or that relapses within 24 months of second-line or above systemic treatment (r/r FL), making it the first CAR-T product approved as a Category 1 biologics product in China. Currently, it is the only CAR-T product in China that has been simultaneously included in the National Significant New Drug Development Program, priority review and breakthrough therapy designations.