以 Polatuzumab 为基础的方案或 CAR-T 细胞治疗复发/难治性弥漫大 B 细胞淋巴瘤患者——匹配队列分析

Polatuzumab (Pola)-based regimens and chimeric antigen receptor T (CAR T) cells provide superior outcome compared to conventional chemoimmunotherapy in patients with relapsed/refractory diffuse large B cell lymphoma (R/R DLBCL). Choosing between these strategies remains controversial. The efficacy of CAR T versus Pola-rituximab(R) /Pola-bendamustine(B)-R in R/R DLBCL patients after failing 2 lines of treatment was compared in a retrospective, 'real-world' study. Propensity score matching, for age, lymphoma category (de-novo/transformed), number of prior lines, Eastern Cooperative Oncology Group performance status and lactate dehydrogenase level, was applied to control for differences in patients' characteristics. Response rate, progression-free survival (PFS) and overall survival (OS) were analyzed.

A total of 82 patients, treated with CAR T (n=41) or Pola-based regimens (n=41), were included. No treatment-related deaths occurred with CAR T vs. 3 (7. 3%) with Pola. The overall and complete response rates were 83% and 58% with CAR T vs. 66% and 44% with Pola-based-regimens (p=0. 077 and p=0. 18, respectively). At a median follow-up of 9 months (range 1-19. 2) and 16 months (range 0. 7-25.

3) for the CAR T and Pola arm respectively, the median PFS has not been reached for CAR T vs. 5. 6 months for Pola (95% CI 3. 6-7. 6, p=0. 014). Median OS has not been reached for CAR T vs. 10. 8 months (95% CI 2. 2-19. 4) for Pola (p=0. 026). To conclude, in a real-world setting, treatment with CAR T achieved superior PFS and OS compared to Pola-based regimens in patients with R/R DLBCL.