不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel：ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
GM-CSF 联合利妥昔单抗和来那度胺的维持方案通过调节 NK 细胞改善高危 B 细胞淋巴瘤的生存
英文原题：Maintenance regimen of GM-CSF with rituximab and lenalidomide improves survival in high-risk B-cell lymphoma by modulating natural killer cells.
查看英文原题
Maintenance regimen of GM-CSF with rituximab and lenalidomide improves survival in high-risk B-cell lymphoma by modulating natural killer cells.
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研究概要
R2+GM-CSF 方案的维持治疗可能改善高危 BCL 患者的生存，其作用可能由 NK 细胞的扩增所介导。R2+GM-CSF 维持方案的疗效尚需在前瞻性随机临床试验中进一步验证。
研究思路结论见上方概要
背景
高危B细胞淋巴瘤（BCL）的治疗仍然是一个挑战，尤其是在老年患者中。
方法
共83例患者（中位年龄65岁），在诱导治疗后达到完全缓解，被分为两组：R 2 + GM-CSF方案（来那度胺、利妥昔单抗、粒细胞-巨噬细胞集落刺激因子[GM-CSF]）作为维持治疗（n = 39）和观察组（n = 44）。分析了R 2 + GM-CSF方案作为高危BCL患者维持治疗的疗效，并与观察组进行了比较。
结果
患者接受 R 2 + GM-CSF 方案后NK 细胞数量增加（0.131 × 10 9 /L vs. 0.061 × 10 9 /L，p = 0.0244）。接受 R 2 + GM-CSF 方案作为维持治疗的患者缓解时间更长（缓解持续时间：18.9 vs. 11.3 个月，p = 0.001），无进展生存期更长（未达到（NR）vs. 31.7 个月，p = 0.037），总生存期（OS）也更长（NR vs. NR，p = 0.015）。R 2 + GM-CSF 方案安全且耐受性良好。高国际预后指数评分（p = 0.012）和高肿瘤负荷（p = 0.005）似乎是 PFS 较差的独立预后因素。
展开英文摘要原文
BACKGROUND
The treatment of high-risk B-cell lymphoma (BCL) remains a challenge, especially in the elderly.
METHODS
A total of 83 patients (median age 65 years), who have achieved a complete response after induction therapy, were divided into two groups: R 2 + GM-CSF regimen (lenalidomide, rituximab, granulocyte-macrophage colony-stimulating factor [GM-CSF]) as maintenance therapy (n = 39) and observation (n = 44). The efficacy of the R 2 + GM-CSF regimen as maintenance in patient with high-risk BCL was analyzed and compared with observation.
RESULTS
The number of natural killer cells in patients increased after R 2 + GM-CSF regimen administration (0.131 × 10 9 /L vs. 0.061 × 10 9 /L, p = 0.0244). Patients receiving the R 2 + GM-CSF regimen as maintenance therapy had longer remission (duration of response: 18.9 vs. 11.3 months, p = 0.001), and longer progression-free survival (not reached (NR) vs. 31.7 months, p = 0.037), and overall survival (OS) (NR vs. NR, p = 0.015). The R 2 + GM-CSF regimen was safe and well tolerated. High international prognostic index score (p = 0.012), and high tumor burden (p = 0.005) appeared to be independent prognostic factors for worse PFS.
CONCLUSIONS
The maintenance therapy of R 2 + GM-CSF regimen may improve survival in high-risk BCL patients, which might be modulated by amplification of natural killer cells. The efficacy of the R 2 + GM-CSF maintenance regimen has to be further validated in prospective random clinical trials.
论文信息
- 作者
- Sun S、Fulati W、Shen L、Wu M、Huang Z、Qian W、Chen P、Hu Y
- 单位
- Department of Hematology, Huadong Hospital Affiliated with Fudan University, Shanghai, China.China
- 文献类型
- 非美国政府资助研究
- 期刊
- Cancer medicine2023 Jun
- 原文标识
- PubMed 37081754 · DOI 10.1002/cam4.5969