英国接受 CD19 CAR-T 治疗的大 B 细胞淋巴瘤患者结局随时间的改善

The success of CD19 Chimeric antigen receptor (CAR) T-cell therapy in large B-cell lymphoma (LBCL) has been partially offset by toxicity and logistical challenges, which off-the-shelf agents like CD20xCD3 bispecific antibodies might potentially overcome.

However, when using CAR T outcomes as the 'standard-of-care comparator for relapsed/refractory (r/r) LBCL, a potential learning curve with implementing a novel, complex therapy like CAR T needs to be considered. To address this, we analysed 726 UK patients intended to be treated with CD19 CAR T for r/r LBCL and compared outcomes between the first year of the national CAR T programme (Era 1; 2019) and the more recent treatment era (Era 2; 2020-2022).

We identified significant improvements for Era 2 versus Era 1 in dropout rate (17% vs. 27%, p = 0. 001), progression-free survival (1-year PFS 50% vs. 32%, p < 0. 001) and overall survival (1-year OS 60% vs. 40%, p < 0. 001).

We also observed increased use of bridging therapy, improvement in bridging outcomes, more tocilizumab/corticosteroid use, reduced high-grade cytokine release syndrome (4% vs. 9%, p = 0. 01) and intensive care unit admissions (20% vs. 32%, p = 0. 001).

Our results demonstrate significant improvement in CAR T outcomes over time, highlighting the importance of using up-to-date clinical data when comparing CAR T against new treatment options for r/r LBCL.