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2017 ASH Pulse Survey

February 23, 2018

This three-question survey of 35 hematologists in the United States and Europe asks respondents their thoughts on CAR T data presented at the 2017 American Society of Hematology (ASH) Annual Meeting.

Survey questions and additional resources are listed further below.

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Survey Questions:
  • Screening Question: Did you follow CAR T data presented at the 2017 American Society of Hematology (ASH) Annual Meeting?
  • Early data from allogeneic CD19 CAR T-cell product, UCART19, were presented for R/R B-cell ALL. In adults, 4/6 pts achieved CRi with MRD-negativity. In children, 5/5 pts achieved CRi and MRD-negativity. GvHD and CRS were easily managed, but 2/5 adults died (1 on D15 of treatment and 1 from infection) and 3/6 pediatric pts died (2 following relapse and 1 from subsequent SCT complications). If these data are reproducible, would you prescribe allo CAR T-cells rather than autologous CAR-T products?
  • Response rates and other efficacy outcomes in CAR T trials are often calculated using actively dosed patients, but not the overall ITT population. For example, in updated results for the Phase I ZUMA-3 trial for Yescarta in R/R ALL, 2/31 patients progressed while waiting CAR T infusion and were no longer eligible for the study nor included in the efficacy analysis. Do you feel it’s necessary to include the ITT population in efficacy analyses?
  • JULIET, a pivotal trial of Kymriah for DLBCL reported 6 month ORR and CR rates (37% and 30%, respectively, n=46) lower than for Gilead’s Yescarta in its pivotal ZUMA-1 trial (41% and 36%, respectively, n=101). Overall survival was 52% for Yescarta at 18 months. Kymriah had more Gr 3/4 CRS (23% vs 13%) but less Gr 3/4 NE (12% vs 28%). There were 3 deaths not due to disease progression in ZUMA-1 but no such deaths in JULIET. Which CAR-T will become the market leader in DLBCL?
Disease Group Covered: Hematology

 Additional Resources: