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CD19 靶向治疗在 CD19 靶向 CAR-T 细胞治疗后复发的复发/难治性大 B 细胞淋巴瘤患者中的疗效

英文原题:Efficacy of CD19 directed therapies in patients with relapsed or refractory large b-cell lymphoma relapsing after CD19 directed chimeric antigen receptor T-cell therapy.

查看英文原题

Efficacy of CD19 directed therapies in patients with relapsed or refractory large b-cell lymphoma relapsing after CD19 directed chimeric antigen receptor T-cell therapy.

PubMed 2023/11/16(内容时间) Bone Marrow Transplant Q1 · IF 5.1(JCR 2025)

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中文摘要

CD19CAR-T 细胞治疗后复发的复发/难治性(R/R)大B细胞淋巴瘤(LBCL)患者结局较差。两种靶向CD19的疗法——tafasitamab联合来那度胺(tafa-len)和loncastuximab tesirine(loncaT)——已获批用于R/R LBCL,但其对CD19 CAR-T 后复发患者的疗效尚不清楚。

我们开展多中心研究,纳入CD19-CAR-T 治疗后因R/R疾病在任一时间接受tafa-len或loncaT的患者。共纳入53例,中位随访时间为CAR-T 输注后56周(范围9.1–199周)。CAR-T 前既往全身治疗线数中位数为3线(范围1–6);最常使用的CAR-T 产品为axi-cel(n=32,60%)。CAR-T 至tafa-len或loncaT治疗的中位间隔为7.3个月(范围1.2–38.2个月),两方案间既往治疗线数中位数为1线(范围0–5)。两种方案合并的总缓解率和完全缓解率分别为27%和10%,中位缓解持续时间为13.3周(范围2.1–56.7周)。这项真实世界研究显示,目前获批的CD19靶向疗法用于CD19 CAR-T 治疗后复发的R/R LBCL时,临床活性和缓解持续时间有限。

展开英文摘要原文

Outcomes are poor for patients with relapsed and/or refractory (R/R) large B-cell lymphoma (LBCL) post chimeric antigen receptor T-cell (CAR-T) therapy. Two CD19-directed therapies, tafasitamab- cxix plus lenalidomide (tafa-len) and loncastuximab tesirine (loncaT) are approved in R/R LBCL. The efficacy of these CD19 directed therapies in patients who relapse after CD19 directed CAR-T (CD19-CART) therapy is not well understood.

We conducted a multi-center study of patients with R/R LBCL that received either tafa-len or loncaT at any timepoint for R/R disease after CD19-CART therapy. Fifty-three patients were included in this study with the median follow up of 56 (9. 1-199) weeks from CAR-T infusion. Median number of systemic therapies pre-CAR-T therapy was 3 (range: 1-6); axicabtagene ciloleucel was the most utilized CAR-T product (n = 32,60%). Median time from CAR-T therapy to tafa-len or loncaT was 7.

3 (1. 2-38. 2) months with median number of lines of therapy between CAR-T therapy and these regimens of 1 (0-5). Combined overall response rate and complete response rates were 27% and 10%, respectively. Median duration of response was 13. 3 (2. 1-56. 7) weeks. In this real-world study, the use of currently approved CD19-directed therapies to treat R/R LBCL after CD19-CAR-T therapy showed limited clinical activity and duration of responses.

论文信息

作者
Iqbal M、Jagadeesh D、Chavez J、Khurana A、Rosenthal A、Craver E、Epperla N、Li Z
单位
Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA. Iqbal.Madiha@Mayo.Edu.United States
文献类型
多中心研究
期刊
Bone marrow transplantation2024 Feb
原文标识
PubMed 37973893 · DOI 10.1038/s41409-023-02148-4