Non-Hodgkin’s Lymphoma: KOL Insight [2018]

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Publication Date:
September 2018
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What impact will CAR-T therapies have on the NHL treatment landscape?

The non-Hodgkin’s lymphoma (NHL) treatment armamentarium has been dominated by rituximab-based chemotherapy regimens for over a decade. Last year witnessed a breakthrough with the approval of two anti-CD19 CAR-T cell therapies (Gilead/Kite’s Yescarta and Novartis’ Kymriah). Find out how KOLs perceive CAR-T therapies amongst many other marketed therapy classes, which also include Bruton’s tyrosine kinase (BTK) inhibitors, PI3 kinase (PI3K) inhibitors and immunomodulatory agents. Find out which therapeutic strategy KOLs think offers the most promise in each NHL subtype and how they will impact future treatment pathways. The experts also provide detailed insights on key pipeline therapy classes including PD-1/PD-L1 inhibitors, antibody-drug conjugates and anti-CD19 targeted agents. Learn how KOLs see the market evolving, and how developers can differentiate their marketed and pipeline therapies in KOL Insight: Non-Hodgkin’s Lymphoma [2018]. Twelve of the world’s foremost KOLs from the US and Europe provide their candid insights on 14 marketed products and 10 pipeline programmes.

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Top takeaways

  • How will chemoimmunotherapy treatment evolve in NHL? What do KOLs think about the future role of anti-CD20-based treatment and will Rituxan/MabThera (rituximab; Roche) remain the gold-standard option? 
  • How will Gazyva/Gazyvaro, rituximab biosimilars and subcutaneous Rituxan impact the future NHL market? Find out how KOLs think the market will segment between rituximab biosimilars, next-generation anti-CD20 agent Gazyva/Gazyvaro and the subcutaneous formulation of Rituxan (Rituxan Hycela).
  • Where will BTK inhibitors, PI3K inhibitors and immunomodulatory drugs be positioned in NHL? Find out how the experts perceive key treatment strategies such as BTK inhibitors (Imbruvica, Calquence), PI3K inhibitors (Zydelig, Aliqopa) and immunomodulatory agents (Revlimid).
  • Can CAR-T cell therapies revolutionise the future treatment of NHL? How do KOLs view the two newly approved anti-CD19 CAR-T therapies (Yescarta and Kymriah) and what are their expectations for other CAR-T therapy approaches from Juno/Celgene.
  • How do KOLs view PD-1/PD-L1 inhibition as a therapeutic strategy in NHL? Merck & Co.’s Keytruda (pembrolizumab) was recently approved for patients with PMBCL. Find out how the experts view Keytruda along with pipeline drugs Bavencio and Opdivo.
  • What pipeline therapies are KOLs most excited about? The NHL pipeline includes numerous targeted agents such as AbbVie/Roche’s Venclexta/Venclyxto (venetoclax), Amgen’s Blincyto, Roche’s polatuzumab vedotin and MorphoSys/Xencor’s MOR208. Find out which pipeline approach KOLs view as most promising.
  • What unmet needs remain for T-cell lymphoma treatment? How do the experts view recently approved agents Adcetris (brentuximab vedotin; Seattle Genetics) and Poteligeo (mogamulizumab; Kyowa Hakko Kirin) and can they address unmet needs in the T-cell lymphomas?
  • How will future treatment pathways evolve in NHL? Find out how the treatment of key NHL subtypes (diffuse large B-cell lymphoma [DLBCL], follicular lymphoma and mantle cell lymphoma) are expected to evolve in the future.
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“R-CHOP is always the standard, so, my money is on R-CHOP plus polatuzumab as the trial to keep an eye on. Patients that relapse do terribly badly and my prediction is that in five to ten years, we'll be going straight for CAR-T cells. That is, if we can afford them.”
US Key Opinion Leader

“I think that we are going to move to a chemotherapy-free strategy in first-line [follicular lymphoma]. We could have Revlimid plus rituximab, or Revlimid plus another anti-CD20 in first-line”
EU Key Opinion Leader

Sample of therapies covered

Marketed Therapies

  • Rituxan/MabThera (rituximab; Roche), plus rituximab biosimilars
  • Gazyva/Gazyvaro (obinutuzumab; Roche)
  • Calquence (acalabrutinib; AstraZeneca/Acerta Pharma)
  • Zydelig (idelalisib; Gilead)
  • Aliqopa (copanlisib; Bayer)
  • Revlimid (lenalidomide; Celgene)
  • Keytruda (pembrolizumab; Merck & Co.)
  • Yescarta (axicabtagene ciloleucel; Gilead/Kite Pharma)
  • Kymriah (tisagenlecleucel; Novartis)
  • Velcade (bortezomib; Janssen/Takeda)
  • Adcetris (brentuximab vedotin; Seattle Genetics)
  • Poteligeo (mogamulizumab; Kyowa Hakko Kirin)

Pipeline Therapies

  • Arzerra (ofatumumab; Novartis)
  • Venclexta/Venclyxto (venetoclax; AbbVie/Roche)
  • duvelisib (Verastem)
  • enzastaurin (Denovo Biopharma)
  • Bavencio (avelumab; Merck Group/Pfizer)
  • Opdivo (nivolumab; BMS)
  • JCAR017 (Celgene/Juno Therapeutics)
  • Blincyto (blinatumomab; Amgen)
  • polatuzumab vedotin (Roche)
  • MOR208 (MOR00208/XmAb5574; MorphoSys/Xencor)

KOLs interviewed

KOLs from North America

  • Dr. Bruce D. Cheson MD; Deputy Chief, Division of Hematology/Oncology, Head of Hematology, and Professor of Medicine at Georgetown University Medical Center, Georgetown University Hospital, Washington, DC
  • Dr. Fredrick B. Hagemeister MD; Internist and Professor of Medicine, Department of Lymphoma/Myeloma, Department of Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
  • Dr. William Hikaru Matsui MD; Professor of Oncology at The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • Dr. Craig Moskowitz MD; Professor in the Miller School of Medicine, Department of Medicine and the Division of Hematology, University of Miami, Florida
  • Dr. Jeffrey Sharman MD; Hematologist and Director of research at Willamette Valley Cancer Institute, Eugene, Oregon
  • Dr. Chaitra S. Ujjani MD; Assistant Professor in the Division of Hematology and Oncology at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC

KOLs from Europe

  • Dr. Nicolas Blin MD; Consultant Physician of Hematology at Nantes University Hospital, Nantes, France
  • Dr. Graham Collins MA MBBS MRCP FRCPath DPhil; Consultant in Haematology, Lymphoma and other Lymphoproliferative Disorders, Oxford University Hospitals NHS Trust, Oxford, UK
  • Professor Timothy Illidge BSc PhD FRCP FRCR FRCPath; Professor of Targeted Therapy & Oncology, University of Manchester and Honorary Consultant in Clinical Oncology at Christie Hospital NHS Foundation Trust, Manchester, UK
  • Professor Vadim Ivanov MD PhD; Department of Hematology, Institut Paoli-Calmettes, Marseille, France
  • Dr. Vittorio Montefusco MD; Department of Hematology and Pediatric Onco‐Hematology, IRCCS Foundation National Cancer Institute, Milan, Italy
  • One Anonymous KOL from a leading Haematology Institute in Germany

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