axicabtagene ciloleucel 治疗大 B 细胞淋巴瘤在不同种族和族裔中的真实世界与临床试验结局

Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for relapsed/refractory (R/R) large B-cell lymphoma (LBCL). Despite extensive data supporting its use, outcomes stratified by race and ethnicity groups are limited.

Here, we report clinical outcomes with axi-cel in patients with R/R LBCL by race and ethnicity in both real-world and clinical trial settings. In the real-world setting, 1290 patients who received axi-cel between 2017 and 2020 were identified from the Center for International Blood and Marrow Transplant Research database; 106 and 169 patients were included from the ZUMA-1 and ZUMA-7 trials, respectively.

Overall survival was consistent across race/ethnicity groups.

However, non-Hispanic (NH) Black patients had lower overall response rate (OR, 0. 37; 95% CI, 0. 22-0. 63) and lower complete response rate (OR, 0. 57; 95% CI, 0. 33-0. 97) than NH White patients. NH Black patients also had a shorter progression-free survival vs NH White (HR, 1. 41; 95% CI, 1. 04-1. 90) and NH Asian patients (HR, 1. 67; 95% CI, 1. 08-2. 59). NH Asian patients had a longer duration of response than NH White (HR, 0. 56; 95% CI, 0. 33-0. 94) and Hispanic patients (HR, 0. 54; 95% CI, 0. 30-0.

97). There was no difference in cytokine release syndrome by race/ethnicity; however, higher rates of any-grade immune effector cell-associated neurotoxicity syndrome were observed in NH White patients than in other patients. These results provide important context when treating patients with R/R LBCL with CAR T-cell therapy across different racial and ethnic groups. ZUMA-1 and ZUMA-7 (ClinicalTrials. gov identifiers: #NCT02348216 and #NCT03391466, respectively) are registered on ClinicalTrials. gov.