ZUMA-7 中二线阿基仑赛或标准治疗后续抗淋巴瘤治疗的结局

The optimal management of patients with relapsed/refractory large B-cell lymphoma (LBCL) after disease progression or lack of response to second-line (2L) therapy remains unclear.

Here, we report outcomes among patients who received subsequent antilymphoma therapy per investigator discretion separately by their randomized 2L arm in ZUMA-7, namely axicabtagene ciloleucel (axi-cel) vs standard of care (SOC). Progression-free survival (PFS) and overall survival (OS) were calculated from 3L therapy initiation. In the SOC arm, 127 of 179 randomized patients (71%) received 3L therapy. Median PFS among those who received 3L cellular immunotherapy (n = 68) vs those who did not (n = 59) was 6. 3 vs 1. 9 months, respectively; median OS was 16. 3 vs 9. 5 months, respectively. In the axi-cel arm, 84 of 180 randomized patients (47%) received 3L therapy.

Median PFS among those who received 3L chemotherapy (n = 60) vs cellular immunotherapy (n = 8) was 1. 7 vs 3. 5 months, respectively; median OS was 8. 1 months vs not reached, respectively. Of the 60 patients who received 3L chemotherapy, 10 underwent stem cell transplantation (SCT) after salvage chemotherapy.

Median PFS was 11. 5 vs 1. 6 months, and median OS was 17. 5 vs 7. 2 months for those who did vs did not reach SCT, respectively. Eight patients received 3L cellular immunotherapy after 2L axi-cel. Of these, 6 patients received subsequent SCT in any line; all 6 were alive at data cutoff.

These findings help inform subsequent treatment choices after 2L therapy failure for relapsed/refractory LBCL. The trial was registered at www. clinicaltrials. gov as #NCT03391466.