大 B 细胞淋巴瘤的 axicabtagene ciloleucel 桥接治疗：美国淋巴瘤 CAR-T 联盟结果

During the manufacturing period of autologous chimeric antigen receptor (CAR) T-cell therapy, patients may experience a decline in their condition due to cancer progression. In this study, we investigated the impact of bridging therapy (BT) on the outcome of patients with relapsed/refractory large B-cell lymphoma who received antilymphoma treatment between leukapheresis and axicabtagene ciloleucel (axi-cel) infusion.

We conducted our analysis using data from the multicenter US Lymphoma CAR-T Consortium, with a median follow-up of 33 months (range, 4. 3-42. 1). Out of the 298 patients who underwent leukapheresis, 275 patients received axi-cel. A total 52% of patients (n = 143) who received BT had a higher baseline risk profile than patients who did not receive BT, and these patients, as a group, had inferior outcomes compared with those who did not receive BT.

However, after propensity score matching between the 2 groups, there were no statistically significant differences in overall response rate (77% vs 87%; P = . 13), complete response rate (58% vs 70%; P = . 1), progression-free survival (hazard ratio [HR], 1. 25; P = . 23), and overall survival (HR, 1. 39; P=.

09) between the BT group and the no-BT group, respectively. Analyzing the effects of BT in the whole cohort that underwent leukapheresis regardless of receiving axi-cel (intention-to-treat analysis) showed similar results. Radiation BT resulted in outcomes similar to those observed with nonradiation BT.

Our findings suggest that BT may be safe without a significant impact on long-term survival for patients who require disease stabilization during the manufacturing period.

Moreover, our results suggest that there is no clear advantage to using radiation-based BT over nonradiation-based BT.