提供 CD19 CAR-T 治疗大 B 细胞淋巴瘤的国家级服务——英国真实世界经验

CD19 CAR-T have emerged as a new standard treatment for relapsed/refractory (r/r) large B-cell lymphoma (LBCL). CAR-T real-world (RW) outcomes published to date suggest significant variability across countries.

We provide results of a large national cohort of patients intended to be treated with CAR-T in the UK. Consecutive patients with r/r LBCL approved for CAR-T by the National CAR-T Clinical Panel between December 2018 and November 2020 across all UK CAR-T centres were included. 404/432 patients were approved [292 axicabtagene ciloleucel (axi-cel), 112 tisagenlecleucel (tisa-cel)], 300 (74%) received the cells. 110/300 (38. 3%) patients achieved complete remission (CR) at 6 months (m).

The overall response rate was 77% (52% CR) for axi-cel, 57% (44% CR) for tisa-cel. The 12-month progression-free survival was 41. 8% (axi-cel) and 27. 4% (tisa-cel). Median overall survival for the intention-to-treat population was 10. 5 m, 16. 2 m for infused patients. The incidence of grade 3 cytokine release syndrome and neurotoxicity were 7. 6%/19. 6% for axi-cel and 7. 9%/3. 9% for tisa-cel. This prospective RW population of CAR-T eligible patients offers important insights into the clinical benefit of CD19 CAR-T in LBCL in daily practice.

Our results confirm long-term efficacy in patients receiving treatment similar to the pivotal trials, but highlight the significance of early CAR-T failure.