Caribou keeps the faith

In contrast to its allogeneic Car-T peers, Caribou yesterday doubled down on diffuse large B-cell lymphoma. While last week Adicet scrapped work on this indication, and Allogene moved to wind down work on third-line use in favour of an all-or-nothing first-line study, Caribou says it continues to enrol relapsed/refractory non-Hodgkin’s patients into its Antler study of CB-010, and has “reached alignment” with the FDA on a phase 3 trial that will test CB-010 in second-line DLBCL and start by the year end. Cell therapy players have been hit by a pincer movement in DLBCL: the approved CD20-targeting T-cell engagers Columvi and Epkinly have moved into the third-line setting, while the Car-Ts Yescarta and Breyanzi have been approved second line. Yet Caribou says the FDA has agreed on a phase 3 second-line DLBCL trial that will compare CB-010 against platinum/chemotherapy and autologous stem cell transplantation. Clearly Caribou will have to hope that doctors will want to enrol patients into a second-line DLBCL trial of an unapproved therapy that doesn’t offer them the choice of an approved Car-T treatment. In contrast to Adicet, Allogene and, as of today, Crispr Therapeutics, Caribou hasn't pivoted to autoimmune disease.

The key players in allogeneic Car-T therapy

Note: *gamma-delta Car-T therapy; all others use alpha-beta T cells. Source: company presentations.