在 CAR-T 细胞治疗前或后接受 tafasitamab 联合来那度胺治疗的大 B 细胞淋巴瘤患者的结局

Tafasitamab plus lenalidomide (TAFA-LEN) treatment relevance pre- or post-anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is debated.

We analyzed patients with large B-cell lymphoma in the DESCAR-T registry treated with axi[1]cel or tisa-cel in 3rd line and TAFA-LEN before (n = 15, "TL-pre-CAR-T" set) or directly after (n = 52, "TL-post-CAR-T" set) CAR T-cell therapy.

We compared TAFA-LEN v. other treatments using inverse probability weighting in the TL-post-CAR[1]T set. In the TL-post-CAR-T set, the median progression-free survival (mPFS), overall survival (mOS), and duration of response (mDOR) since the first treatment for progression (mPFS2/mOS2/mDOR2) were 3, 4. 7, and 8. 1 months, respectively. The best overall response rate (bORR) and best complete response rate (bCRR) after TAFA-LEN were 13. 5% and 7. 7%, respectively. Outcomes were better for patients who relapsed >6 months after CAR T-cell therapy (mPFS2: 5. 6 vs 2 months, P = . 0138; mOS2: not reached vs 3. 8 months, P = . 0034).

The bORR and bCRR between TAFA-LEN and other treatments were 20. 6% vs 24. 9% and 11. 6% vs 15. 6%, respectively. Outcomes were similar between TAFA-LEN and other treatments (mPFS2: 2. 9 vs 2. 4 months, P = . 91; mOS2: 3. 3 vs 5. 5 months, P = . 06). In an exploratory analysis of the TL-pre-CAR-T set, the median TAFA-LEN treatment duration before CAR-T was 3.

7 months with no patient becoming CD19 negative. The bORR, bCRR, 6- month PFS, and OS rates after CAR T-cell infusion were 45. 5%, 36. 4%, 20. 1%, and 58. 2%, respectively. Neither TAFA-LEN nor comparative salvage treatment improved outcomes for patients relapsing after CAR T-cell therapy.