The 'HemOnc Pulse Live' Controversies in Aggressive NHL

In this episode, Mehdi Hamadani leads an expert conversation on the ongoing challenges and innovations in the treatment of aggressive non-Hodgkin lymphoma, with a particular focus on chimeric antigen receptor (CAR) T-cell therapies. Joined by Timothy Fenske, MD Madiha Iqbal, MBBS, MD, Urshila Durani, MD, MPH, and Mohamed Kharfan-Dabaja, MD, MBA the group explores critical clinical questions, emerging therapeutic strategies, and the future of allogeneic CAR T-cell therapy.

The panel reflects on the limitations of current CD19-directed therapies, noting that despite progress, more than half of patients still relapse within five years. The discussion highlights the urgent need to identify patients who are unlikely to benefit from existing therapies and to develop new treatment constructs beyond CD19 targeting. Participants analyze recent data from promising CAR T constructs, including Allogene’s early trials and Caribou’s PD-1 knockout designs, examining their potential roles in frontline and second-line settings.

A recurring theme is the potential of allogeneic CAR T therapy as a game-changing modality—particularly if new targets can help overcome issues like antigen escape. Panelists discuss ongoing studies targeting the BAFF receptor and debate the practicality and ethics of early T-cell collection in high-risk patients.

The conversation also touches on logistical and economic considerations, such as the feasibility of storing T cells for future use and whether off-the-shelf therapies can be cost-effective alternatives to autologous options. Throughout the session, the experts weigh scientific promise against real-world clinical constraints, offering a nuanced look at where lymphoma treatment is heading.

Rich in data, opinion, and forward-thinking ideas, this panel is essential listening for clinicians, researchers, and industry professionals invested in the evolving landscape of aggressive lymphoma care. The session underscores the importance of collaboration and innovation to meet the unmet needs in relapsed and refractory disease.