Outcome after chimeric antigen receptor (CAR) T-cell therapy failure in large B-cell lymphomas.
Anna DoderoStefania BramantiMartina Di TraniMartina PennisiSilva LjevarAnnalisa ChiappellaMagagnoli MassimoAnna GuidettiFrancesco CorradoPaulina Maria NierychlewskaAlice Di RoccoDaniele LorenziniRahal DaoudChiara De PhilippisArmando SantoroCarmelo Carlo-StellaPaolo CorradiniPublished in: British journal of haematology (2023)
This study retrospectively evaluated the outcome of salvage therapy in 51 patients who failed axicabtagene ciloleucel or tisagenlecleucel for relapsed/refractory large B-cell lymphomas. Of these patients, 22 (43%) were enrolled in clinical trials (glofitamab or loncastuximab tesirine + ibrutinib), whereas 29 received standard therapies (lenalidomide [Len], checkpoint inhibitors [CPIs], ibrutinib [I], chemoimmunotherapy and radiotherapy) or supportive care. Overall, 26 of 39 (67%) treated patients received a treatment based on immunotherapy (glofitamab, CPI, Len) that was mainly represented by bispecific antibody (n = 18). In this subgroup, plasma samples were collected and analysed for circulating tumour DNA (ctDNA) using cancer-personalized profiling by deep sequencing (CAPP-seq). The study found that patients with high ctDNA had poor outcomes. At a median follow-up of 11.7 months, the estimated 12-month overall survival (OS) was 35%. Factors adversely affecting the prognosis in the multivariable model were the absence of response to CAR T-cell therapy (HR: 3.08; p = 0.0109) and a diagnosis other than PMBCL and t-FL (HR: 4.54; p = 0.0069). The outcome of patients failing CAR T cells is poor and requires further investigation.
Keyphrases
- cell therapy
- end stage renal disease
- newly diagnosed
- ejection fraction
- clinical trial
- chronic kidney disease
- healthcare
- prognostic factors
- acute myeloid leukemia
- metabolic syndrome
- type diabetes
- early stage
- randomized controlled trial
- peritoneal dialysis
- palliative care
- radiation therapy
- dna damage
- squamous cell carcinoma
- low dose
- bone marrow
- patient reported outcomes
- insulin resistance
- diffuse large b cell lymphoma
- chronic pain
- high dose
- radiation induced
- papillary thyroid
- phase ii