不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Anti-PD-1 antibody (Tislelizumab) combined with gemcitabine and oxaliplatin for extranodal NK/T-cell lymphoma failing asparaginase: A multicenter phase II trial.
Anti-PD-1 antibody (Tislelizumab) combined with gemcitabine and oxaliplatin for extranodal NK/T-cell lymphoma failing asparaginase: A multicenter phase II trial.
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替雷利珠单抗联合吉西他滨和奥沙利铂(Tisle-GemOx)作为对门冬酰胺酶治疗失败的结外 NK/T 细胞淋巴瘤(ENKTCL)的挽救治疗,显示出有前景的抗肿瘤活性和可控的毒性。需要进一步长期随访,以评估替雷利珠单抗维持治疗在该患者群体中缓解的持久性。
结外NK/T细胞淋巴瘤(ENKTCL)在门冬酰胺酶治疗失败后几乎总是致命的。这项II期研究旨在探讨替雷利珠单抗联合吉西他滨和奥沙利铂(Tisle-GemOx)在门冬酰胺酶治疗失败的ENKTCL患者中的疗效和安全性。
符合条件的患者接受Tisle-GemOx作为初始诱导治疗,每21天为一个周期,共6-8个周期。有应答者继续接受替雷利珠单抗维持治疗,每两个月一次,持续两年。主要终点是最佳完全缓解率(CRR)。
截至2023年9月,共有32例患者入组我们的研究。在30例可评估疗效的患者中,最佳CRR为60 %,达到主要疗效终点。中位随访时间为22.6个月,中位无进展生存期(PFS)为7.4个月,1年PFS率为46.4 %。亚组分析显示,较短的PFS与既往化疗线数≥ 2(P = 0.034)和合并噬血细胞性淋巴组织细胞增生症(P = 0.040)相关。3例患者(10 %)出现假性进展。最常见的≥ 3级毒性为淋巴细胞减少(25 %)和贫血(15.6 %)。
Extranodal natural killer/T-cell lymphoma (ENKTCL) is almost always fatal after the failure of asparaginase. This phase II study aimed to investigate the efficacy and safety of tislelizumab combined with gemcitabine and oxaliplatin (Tisle-GemOx) in patients with ENKTCL failing asparaginase.
Eligible patients received Tisle-GemOx as initial induction for 6-8 cycles at 21-day intervals. Responders continued tislelizumab maintenance every two months for two years. The primary endpoint was the best complete response rate (CRR).
As of September 2023, 32 patients were enrolled in our study. Among the 30 efficacy-evaluable patients, the best CRR was 60 %, meeting the primary efficacy endpoint. With a median follow-up of 22.6 months, the median progression-free survival (PFS) was 7.4 months and the 1-year PFS rate was 46.4 %. Subgroup analyses showed that shorter PFS was associated with previous lines of chemotherapy ≥ 2 (P = 0.034) and concomitant hemophagocytic lymphohistiocytosis (P = 0.040). Pseudo-progression was observed in three patients (10 %). The most common grade ≥ 3 toxicities were lymphopenia (25 %) and anemia (15.6 %).
Tisle-GemOx exhibits promising anti-tumor activity and manageable toxicities as a salvage therapy for ENKTCL failing asparaginase. Further long-term follow-up is necessary to evaluate the durability of the response with tislelizumab maintenance in this patient population.
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