Expert Interview
Digging in to the Affimed IV data on AFM13 in Lymphoma presented at AACR
Ticker(s): AFMDInstitution: Moffitt Cancer Center
- Co-Director of the Cutaneous Lymphoma Multidisciplinary Clinic at Moffitt for over 15 years
- Treats several hundred patients with Hodgkin or non-Hodgkin lymphoma and has participated in numerous clinical trials for T cell malignancies including pivotal studies with romidepsin and mogamulizumab. He also led clinical research in T-cell and NK-cell large granular lymphocytic leukemia (LGL)
- Clinical and laboratory work has been focused on T-cell lymphomas and leukemias and rare lymphoproliferative and histiocytic disorders including Castleman disease, Langerhans Cell Histiocytosis, Hemophagocytic LymphoHistiocytosis, Rosai-Dorfman Disease, etc.
Please discuss the patient population enrolled in this trial. Median prior lines 7 with range of 1 to 14, all had prior Adcetris, all but one had prior PD-1, majority with prior SCT --- How common is this sort of patient?
Is there any standard of care for these patients after they already had Adcetris and pembro? What efficacy would you expect with what's available? What do you set as the bar for level of response in this very refractory setting to consider something as a promising treatment?
When patients have had so many prior lines of therapy, on the one hand that shows their disease has been difficult to cure but on the other hand, could it select for patients who are likely to survive even though disease comes back and forth? How do you view efficacy in light of that context?
Please comment on durability data thus far. What is the bar for durability of response that you want to see to be convinced this therapy is viable?
Please describe your view of the safety profile. 0 CRS, GvHD, or neurotoxicity was observed.
AEs seem to be driven by FluCy lymphodepletion. Here they gave 2 cycles. Is it feasible to give repeat cycles of this to patients? Is it tolerable?
Since 2 cycles improved the CR rate from 38% to 62% at the highest dose level, should they be giving more cycles? If it had potential as a maintenance therapy after the initial 2 cycles, how often could it be reasonably dosed? Every 6 months? Every year? Longer?
The investigators seem very convinced that the AFM13 is contributing to this combo and that the cytokine-preactivated NK cells could not achieve these results as monotherapy without AFM13. Preclinical data is supportive of this concept. In your view, are you convinced that the AFM13 is contributing as part of this combo or do you have doubts about that?
What response rates would you expect for preactivated cbNK cells alone in Hodgkin's lymphoma?
Is the bar set too high by agents used in earlier lines, or could this potentially be moved to more of a frontline treatment? Would response be better in less refractory patients? Thoughts on combination approaches with other agents +AFM13+cbNK?
Is a ~2-week period to prepare the cells with cytokines and AFM13 and start the infusions a reasonable length of time for initiating treatment in HL with progressive disease?
Based on the data so far, if you had to rate your level of excitement about cbNK cells + AFM13 on a scale of 1-10 where would you put that and why?
Added By: sara_admin Please describe your clinical practice. How many Hodgkin's Lymphoma patients do you treat?
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