Case Files: Axatilimab Use in a Patient With Chronic Graft-Versus-Host-Disease 

Moderator: Welcome to this podcast titled Case Files: Axatilimab Use in a Patient With Chronic Graft-Versus-Host Disease, or GVHD. I’m Jenny Lamberts with Oncology Learning Network, and I’m pleased you’ve tuned in to listen today. 

In this episode, we’ll focus on the role of axatilimab in treating chronic GVHD. For patients not achieving their treatment goals with existing therapies, axatilimab has emerged as an important option in the third-line and beyond setting. 

To guide us through this topic, we’re joined by Dr Benjamin Watkins, who will highlight how axatilimab fits in the treatment sequence and key considerations for its use. Welcome, Dr Watkins! 

Dr Watkins: My name is Ben Watkins. I'm the division chief of pediatric hematology and oncology at Tulane University, and I'm the director of stem cell transplant, cell and gene therapy at Manning Family Children's in New Orleans. 

The latest drug on the market that's really just come on in the last year or so is axatilimab. So, axatilimab is a little bit unique in that it has a different target. So, ruxolitinib is JAK-STAT, mainly involved in T-cell inhibition as well as involved in T-cell trafficking. Ibrutinib works on B and T cells; however, the way the axatilimab works is it blocks the receptor for colony-stimulating factor that monocytes and macrophages utilize. 

So, one of the latter phases of chronic graft-versus-host-disease is really hallmarked by monocyte macrophage activation, which leads to a lot of fibrosis and sclerotic features of chronic GVHD. This tends to be the hardest type of graft-versus-host disease to treat. It's really difficult to get responses once you develop this type of GVHD. However, axatilimab works by specifically targeting that monocyte and macrophage activation. So, in clinical trials, it's shown promise in both inflammatory, but I think where the most promise for me is more in the fibrotic forms of chronic GVHD. So, thank you for listening to this. I hope this helps when you consider treating patients with chronic graft-versus-host disease. And I appreciate you listening.  

Moderator: Thank you, Dr Watkins, for illustrating how axatilimab can be integrated into managing chronic GVHD.  

For patients not meeting their treatment goals with other therapies, axatilimab offers a vital option in the third-line and beyond setting. The key is knowing when to transition and how to integrate this therapy into practice to support patient outcomes.  

On behalf of our team, thank you for joining us today.