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复发/难治性侵袭性大 B 细胞淋巴瘤患者化疗免疫治疗与新型治疗的真实世界疗效

英文原题:Real-World Effectiveness of Chemoimmunotherapy and Novel Therapies for Patients With Relapsed/Refractory Aggressive Large B-Cell Lymphoma.

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Real-World Effectiveness of Chemoimmunotherapy and Novel Therapies for Patients With Relapsed/Refractory Aggressive Large B-Cell Lymphoma.

PubMed 2024/12/16(内容时间) Clin Lymphoma Myeloma Leuk Q1 · IF 4.1(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

研究概要

r/r LBCL 患者预后不佳,需要更有效的治疗选择。

研究思路结论见上方概要

临床试验为新疗法的安全性和有效性提供了有意义的数据,但新药获批时间与真实世界实践中治疗后临床结局信息之间往往存在滞后。本研究评估了大量真实世界复发和/或难治性大B细胞淋巴瘤(r/r LBCL)患者的临床结局,这些患者接受了二线或更后线治疗(2L+)的化学免疫治疗或新疗法。

分析了来自淋巴瘤流行病学结局(LEO)联盟真实世界证据(CReWE)队列(2015年1月1日至2023年2月15日)的数据。描述了患者的人口学和临床特征,并评估了缓解率、缓解持续时间、无进展生存期和总生存期。使用多变量Cox比例风险回归模型评估患者临床特征与结局之间的关联。

2L+队列包括接受化学免疫治疗(N = 593)、来那度胺为基础的治疗(n = 60)、polatuzumab vedotin为基础的治疗(N = 116)、tafasitamab为基础的治疗(N = 55)和loncastuximab tesirine(N = 42)治疗的患者。大多数既往接受过CAR-T 细胞治疗(CAR-T)的患者对该治疗无效。在所有患者中,总体缓解率<50%,四分之一达到完全缓解,接受化学免疫治疗或新型疗法的患者中位缓解持续时间和总生存期较短(分别<6个月和<10个月)。既往接受过CAR-T 的患者预后更差。原发性难治状态、高危疾病和失败3线或以上治疗与更差的结果显著相关。

展开英文摘要原文

Data from the Lymphoma Epidemiology of Outcomes (LEO) Consortium of Real-World Evidence (CReWE) cohort (1/1/2015-2/15/2023) were analyzed. Patients' demographic and clinical characteristics were described and response rates, duration of response, progression-free survival, and overall survival were evaluated. Multivariable Cox proportional hazards regression models were used to assess associations between patient clinical characteristics and outcomes.

The 2L+ cohort included patients treated with chemoimmunotherapy (N = 593), lenalidomide-based therapy (n = 60), polatuzumab vedotin-based therapy (N = 116), tafasitamab-based therapy (N = 55), and loncastuximab tesirine (N = 42). Most patients who received prior chimeric antigen receptor T-cell therapy (CAR-T) were refractory to the treatment. Across all patients, overall response rates were <50%, with one-quarter achieving complete response and median duration of response and overall survival were short (<6 and <10 months, respectively) among patients treated with chemoimmunotherapy or novel therapies. The prognosis was worse for patients who had previously received CAR-T. Primary refractory status, high-risk disease, and failing 3 or more lines of therapy were significantly associated with worse outcomes.

Patients with r/r LBCL have unfavorable outcomes and need more effective treatment alternatives.

论文信息

作者
Nastoupil LJ、Andersen CR、Ayers A、Wang Y、Habermann TM、Chihara D、Kahl BS、Link BK
单位
Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston, TX. Electronic address: LNastoupil@mdanderson.org.United States
期刊
Clinical lymphoma, myeloma & leukemia2025 Apr
原文标识
PubMed 39966020 · DOI 10.1016/j.clml.2024.11.014