Encouraging New Data Presented on Kite’s Yescarta® for Relapsed/Refractory Central Nervous System Lymphoma
Kite, a Gilead Company (Nasdaq: GILD), presented promising data on Yescarta® for relapsed/refractory CNS lymphoma at the 2024 ASCO Annual Meeting. The pilot study, conducted with Dana-Farber Cancer Institute, revealed that Yescarta® is well-tolerated in patients with R/R central nervous system lymphoma (CNSL), showing a high objective response rate of 94.4% and a complete response rate of 66.7%. The median progression-free survival was 14.3 months, and overall survival was 26.4 months. The study showed no additional risk of adverse events, with immune effector cell-associated neurologic syndrome observed in 44% of patients. These results suggest that Yescarta could be a viable treatment option for this aggressive and rare form of lymphoma.
- High objective response rate of 94.4%.
- Complete response rate of 66.7%.
- Median progression-free survival of 14.3 months.
- Median overall survival of 26.4 months.
- No additional risks of adverse events observed.
- Data presented at a prestigious event, the 2024 ASCO Annual Meeting.
- Potential new treatment option for an area of unmet clinical need.
- 44% of patients experienced immune effector cell-associated neurologic syndrome.
- 27.8% of patients had Grade ≥3 neurologic toxicities.
- 90% of patients developed grade 1 or 2 cytokine release syndrome.
- Seven patients died due to disease progression.
Insights
The latest findings on Yescarta® for treating relapsed/refractory central nervous system lymphoma (CNSL) are promising, particularly given the lack of effective treatment options for this aggressive and rare form of non-Hodgkin lymphoma. The study, conducted in collaboration with Dana-Farber Cancer Institute, shows that Yescarta is well-tolerated, with no additional risks of adverse events after 24.2 months, a significant follow-up duration given the aggressive nature of the disease. The high objective response rate of
It is important to clarify that these results are preliminary and come from a small sample size. Further extensive studies are required to consolidate these findings. However, the durability of response over a median of 13.4 months, with manageable levels of adverse events like Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) and cytokine release syndrome (CRS), indicates a positive step. From an investor's perspective, this suggests that Yescarta could potentially fill a significant unmet need in the market, leading to broader applications and increased market share in oncology.
From a financial perspective, the positive data on Yescarta® could have a significant impact on Gilead's revenue stream. Yescarta is already a key product in Gilead's oncology portfolio and expanding its indications to include CNSL could unlock new revenue channels. The objective response rate of
For retail investors, it's important to monitor the ongoing developments and upcoming larger trials that will be needed to confirm these results. Additionally, understanding the associated risks of adverse events, as outlined in the safety profile and the costs of managing these events will be important in assessing the long-term financial impact. In the short term, positive sentiment around this data could boost Gilead's stock, but sustained performance will hinge on further validation.
The promising data on Yescarta® for CNSL could provide Gilead a competitive advantage in the CAR T-cell therapy market. CAR T-cell therapies have been at the forefront of cutting-edge treatments and success in CNSL could position Gilead as a leader in treating rare and aggressive cancers. The high response rates and prolonged survival times reported in this pilot study are significant, especially given the lack of effective treatments for CNSL. If Yescarta can be proven effective in larger trials, it could address a substantial unmet need, which is a compelling market opportunity.
Investors should be aware of the current competitive landscape in CAR T-cell therapies and how Gilead's advancements with Yescarta might compare. Additionally, the regulatory pathway, including potential accelerated approvals based on these promising results, could also play a pivotal role. Long-term market success will depend on continued clinical success, approval for broader indications and effective management of the therapy's side effects. This development thus signals strong growth potential for Gilead in the oncology sector.
-- At Median Follow-Up of 24.2 Months, No Additional Risks of Adverse Events Related to Yescarta Were Observed --
-- Findings Also Suggest Efficacy Trend with Median Progression-Free Survival and Durability of Response of More Than a Year --
-- Data Presented Orally at the 2024 American Society of Clinical Oncology Annual Meeting --
Central nervous system lymphoma (CNSL) is an aggressive and rare form of non-Hodgkin lymphoma that has either originated in (primary) or spread to (secondary) the brain, eye, spinal cord or cerebrospinal fluid. The prognosis of PCNSL has historically been poor with a five-year survival rate of only
“Patients with central nervous system involvement of large B-cell lymphoma were excluded from the studies that led to the FDA approval of axi-cel in relapsed/refractory large B-cell lymphoma,” said Lakshmi Nayak, MD, Associate Professor of Neurology, Harvard Medical School and Director of the Center for CNS Lymphoma, Dana-Farber Cancer Institute. “We conducted this pilot study to evaluate the safety of axi-cel in CNSL patients and to see if there would be a preliminary signal of efficacy. Not only did we see a high response rate with axi-cel in this heavily pre-treated population, but importantly they were durable. While we need more data to evaluate axi-cel in a larger study, these results are promising and represent a potential breakthrough in the treatment of this particularly rare and aggressive brain cancer for which there are limited options when it recurs.”
In this pilot study of 18 patients with CNSL, at a median follow-up of 24.2 months, no treatment-limiting toxicities and no apparent additional risk of adverse events were reported. Immune effector cell-associated neurologic syndrome (ICANS) was observed among
The objective response rate was
Ninety percent of patients developed grade 1 or 2 cytokine release syndrome; two patients developed Ommaya-related meningitis requiring explant with subsequent recovery. One patient developed grade 3 electrographic focal status epilepticus that resolved with anti-epileptic agents. Seven patients have died, all from disease progression.
“We are very encouraged by the data presented today that indicate the potential to extend the benefits of Yescarta to people with relapsed/refractory primary and secondary central nervous system lymphoma, whose prognoses are typically very poor,” said Ibrahim Elhoussieny, MD, Vice President, Medical Affairs, Kite. “These early data support that CAR T-cell therapy may potentially offer a treatment option to these patients.”
The Yescarta
About Central Nervous System Lymphoma
Central nervous system lymphoma (CNSL) is an aggressive and rare form of non-Hodgkin lymphoma that has either originated in (primary) or spread (secondary) to the brain, eye, spinal cord or cerebral spinal fluid. The prognosis of PCNSL has historically been poor with a five-year survival rate of only
There is an estimated annual incidence of 1,500 cases of primary CNSL in
About the Study
The pilot study enrolled 18 patients (13 PCNSL, 4 SCNSL, 1 concurrent systemic and ocular lymphoma), of whom the first six patients were observed for treatment-limiting toxicities (TLTs). The primary endpoint was safety, measured by rate of TLTs and grade 3+ adverse events (AEs). Secondary endpoints included objective response rate, complete response rate, duration of response, progression-free survival and overall survival (OS).
About Yescarta
Please see full US Prescribing Information, including BOXED WARNING and Medication Guide.
YESCARTA is a CD19-directed genetically modified autologous T cell immunotherapy indicated for the treatment of:
- Adult patients with large B-cell lymphoma that is refractory to first-line chemoimmunotherapy or that relapses within 12 months of first-line chemoimmunotherapy.
- Adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, primary mediastinal large B-cell lymphoma, high-grade B-cell lymphoma, and DLBCL arising from follicular lymphoma.
Limitations of Use: YESCARTA is not indicated for the treatment of patients with primary central nervous system lymphoma.
- Adult patients with relapsed or refractory follicular lymphoma (FL) after two or more lines of systemic therapy. This indication is approved under accelerated approval based on the response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trial(s).
BOXED WARNING: CYTOKINE RELEASE SYNDROME, NEUROLOGIC TOXICITIES, and SECONDARY HEMATOLOGICAL MALIGNANCIES
- Cytokine Release Syndrome (CRS), including fatal or life-threatening reactions, occurred in patients receiving YESCARTA. Do not administer YESCARTA to patients with active infection or inflammatory disorders. Treat severe or life-threatening CRS with tocilizumab or tocilizumab and corticosteroids.
- Neurologic toxicities, including fatal or life-threatening reactions, occurred in patients receiving YESCARTA, including concurrently with CRS or after CRS resolution. Monitor for neurologic toxicities after treatment with YESCARTA. Provide supportive care and/or corticosteroids as needed.
- T-cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T cell immunotherapies, including YESCARTA.
- YESCARTA is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the YESCARTA and TECARTUS REMS Program.
CYTOKINE RELEASE SYNDROME (CRS)
CRS, including fatal or life-threatening reactions, occurred following treatment with YESCARTA. CRS occurred in
CRS occurred in
Key manifestations of CRS (≥
The impact of tocilizumab and/or corticosteroids on the incidence and severity of CRS was assessed in 2 subsequent cohorts of LBCL patients in ZUMA-1. Among patients who received tocilizumab and/or corticosteroids for ongoing Grade 1 events, CRS occurred in
Ensure that 2 doses of tocilizumab are available prior to YESCARTA infusion. Monitor patients for signs and symptoms of CRS at least daily for 7 days at the certified healthcare facility, and for 4 weeks thereafter. Counsel patients to seek immediate medical attention should signs or symptoms of CRS occur at any time. At the first sign of CRS, institute treatment with supportive care, tocilizumab, or tocilizumab and corticosteroids as indicated.
NEUROLOGIC TOXICITIES
Neurologic toxicities (including immune effector cell-associated neurotoxicity syndrome) that were fatal or life-threatening occurred. Neurologic toxicities occurred in
The most common neurologic toxicities (≥
The impact of tocilizumab and/or corticosteroids on the incidence and severity of neurologic toxicities was assessed in 2 subsequent cohorts of LBCL patients in ZUMA-1. Among patients who received corticosteroids at the onset of Grade 1 toxicities, neurologic toxicities occurred in
Monitor patients for signs and symptoms of neurologic toxicities at least daily for 7 days at the certified healthcare facility, and for 4 weeks thereafter, and treat promptly.
REMS
Because of the risk of CRS and neurologic toxicities, YESCARTA is available only through a restricted program called the YESCARTA and TECARTUS REMS Program which requires that: Healthcare facilities that dispense and administer YESCARTA must be enrolled and comply with the REMS requirements and must have on-site, immediate access to a minimum of 2 doses of tocilizumab for each patient for infusion within 2 hours after YESCARTA infusion, if needed for treatment of CRS. Certified healthcare facilities must ensure that healthcare providers who prescribe, dispense, or administer YESCARTA are trained in the management of CRS and neurologic toxicities. Further information is available at www.YescartaTecartusREMS.com or 1-844-454-KITE (5483).
HYPERSENSITIVITY REACTIONS
Allergic reactions, including serious hypersensitivity reactions or anaphylaxis, may occur with the infusion of YESCARTA.
SERIOUS INFECTIONS
Severe or life-threatening infections occurred. Infections (all grades) occurred in
Febrile neutropenia was observed in
In immunosuppressed patients, including those who have received YESCARTA, life-threatening and fatal opportunistic infections including disseminated fungal infections (e.g., candida sepsis and aspergillus infections) and viral reactivation (e.g., human herpes virus-6 [HHV-6] encephalitis and JC virus progressive multifocal leukoencephalopathy [PML]) have been reported. The possibility of HHV-6 encephalitis and PML should be considered in immunosuppressed patients with neurologic events and appropriate diagnostic evaluations should be performed.
Hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death, can occur in patients treated with drugs directed against B cells, including YESCARTA. Perform screening for HBV, HCV, and HIV in accordance with clinical guidelines before collection of cells for manufacturing.
PROLONGED CYTOPENIAS
Patients may exhibit cytopenias for several weeks following lymphodepleting chemotherapy and YESCARTA infusion. ≥ Grade 3 cytopenias not resolved by Day 30 following YESCARTA infusion occurred in
HYPOGAMMAGLOBULINEMIA
B-cell aplasia and hypogammaglobulinemia can occur. Hypogammaglobulinemia was reported as an adverse reaction in
SECONDARY MALIGNANCIES
Patients treated with YESCARTA may develop secondary malignancies. T-cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T-cell immunotherapies, including YESCARTA. Mature T-cell malignancies, including CAR-positive tumors, may present as soon as weeks following infusion, and may include fatal outcomes.
Monitor life-long for secondary malignancies. In the event that a secondary malignancy occurs, contact Kite at 1-844-454-KITE (5483) to obtain instructions on patient samples to collect for testing.
EFFECTS ON ABILITY TO DRIVE AND USE MACHINES
Due to the potential for neurologic events, including altered mental status or seizures, patients are at risk for altered or decreased consciousness or coordination in the 8 weeks following YESCARTA infusion. Advise patients to refrain from driving and engaging in hazardous occupations or activities, such as operating heavy or potentially dangerous machinery, during this initial period.
ADVERSE REACTIONS
The most common non-laboratory adverse reactions (incidence ≥
The most common adverse reactions (incidence ≥
The most common non-laboratory adverse reactions (incidence ≥
About Kite
Kite, a Gilead Company, is a global biopharmaceutical company based in
About Gilead Sciences
Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis and cancer. Gilead operates in more than 35 countries worldwide, with headquarters in
Forward-Looking Statements
This press release includes forward-looking statements, within the meaning of the Private Securities Litigation Reform Act of 1995 that are subject to risks, uncertainties and other factors, including the ability of Gilead and Kite to initiate, progress or complete clinical trials within currently anticipated timelines or at all, and the possibility of unfavorable results from ongoing or additional clinical studies, including those involving Yescarta (such as the foregoing pilot study); the possibility that Gilead and Kite may make a strategic decision to discontinue development of programs for indications that are currently under evaluation and, as a result, these programs may never be successfully commercialized for such indications; and any assumptions underlying any of the foregoing. These and other risks, uncertainties and factors are described in detail in Gilead’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2024, as filed with the
Kite, the Kite logo, Yescarta, and GILEAD are trademarks of Gilead Sciences, Inc. or its related companies.
For more information on Kite, please visit the company’s website at www.kitepharma.com. Follow Kite on social media on X (@KitePharma) and LinkedIn.
View source version on businesswire.com: https://www.businesswire.com/news/home/20240603718191/en/
Jacquie Ross, Investors
Investor_Relations@Gilead.com
Meaghan Smith, Gilead Media
Public_Affairs@Gilead.com
Source: Gilead Sciences, Inc.
FAQ
What is the effectiveness of Yescarta® for relapsed/refractory CNS lymphoma?
What are the survival rates for patients treated with Yescarta® for relapsed/refractory CNS lymphoma?
What is the significance of the 2024 ASCO Annual Meeting for Yescarta®?
What adverse events were observed in the Yescarta® study for CNS lymphoma?