Details

Autor(en) / Beteiligte

• Bethge, WA
• Martus, P
• Schmitt, M
• Holtick, U
• Subklewe, M
• von Tresckow, B
• Ayuk, F
• Wagner-Drouet, EM
• Wulf, G
• Marks, R
• Penack, O
• Schnetzke, U
• Koenecke, C
• von Bonin, M
• Stelljes, M
• Glass, B
• Baldus, CD
• Vucinic, V
• Mougiakakos, D
• Topp, M
• Fante, M
• Schroers, R
• Bayir, L
• Borchmann, P
• Buecklein, V
• Hasenkamp, J
• Hanoun, C
• Thomas, S
• Beelen, D
• Lengerke, C
• Kroeger, N
• Dreger, P

Titel

GLA/DRST real-world outcome analysis of CAR-T cell therapies for large B-cell lymphoma in Germany

Ist Teil von

• Blood, 2022-07, Vol.140 (4), p.349-358

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• CD19-directed chimeric antigen receptor (CAR) T cells have evolved as new standard-of-care (SOC) treatment in patients with relapsed/refractory large B-cell lymphoma (LBCL). Here, we report the first German real-world data on SOC CAR-T cell therapies with the aim to explore risk factors associated with outcome. Patients who received SOC axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) for LBCL and were registered with the German Registry for Stem Cell Transplantation (DRST) were eligible. Main outcomes analyzed were toxicities, response, overall survival (OS), and progression-free survival (PFS). We report 356 patients who received axi-cel (n=173) or tisa-cel (n=183) between November 2018 and April 2021 at 21 German centers. Whereas the axi-cel and tisa-cel cohorts were comparable for age, sex, LDH, IPI, and pretreatment, the tisa-cel group comprised significantly more patients with poor performance status, ineligibility for ZUMA-1, and need for bridging, respectively. With a median follow-up alive of 11 months, Kaplan-Meier estimates of OS, PFS, and non-relapse mortality (NRM) 12 months after dosing were 52%, 30%, and 6%, respectively. While NRM was largely driven by infections subsequent to prolonged neutropenia and/or severe neurotoxicity and significantly higher with axi-cel, significant risk factors for PFS on multivariate analysis included bridging failure, elevated LDH, age, and tisa-cel use. In conclusion, this study suggests that important outcome determinants of CD19-directed CAR-T cell treatment of LBCL in the real-world setting are bridging success, CAR-T product selection, LDH, and the absence of prolonged neutropenia and/or severe neurotoxicity. These findings may have implications for designing risk-adapted CAR-T cell therapy strategies.