决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Glofitamab in refractory or relapsed diffuse large B cell lymphoma after failing CAR-T cell therapy: a phase 2 LYSA study.
glofitamab 改善了 CAR-T 细胞治疗后复发/难治性弥漫大 B 细胞淋巴瘤参与者的总生存期,且安全性良好。
弥漫大 B 细胞淋巴瘤(DLBCL)患者接受CAR-T(CAR-T)细胞治疗后,若疾病难治或首次进展/复发(R/R),结局往往非常不理想。一项单臂、开放标签 II 期试验(NCT04703686)纳入此类患者,评估 CD20-CD3 T 细胞衔接双特异性抗体 glofitamab 的疗效和安全性;采用短期剂量递增方案,在 1 周内达到全剂量。46 名参与者在 obinutuzumab(抗 CD20 单克隆抗体)预处理后,至少接受 1 次 glofitamab 输注。主要终点为总生存期(OS);次要终点包括独立评估的最佳总体代谢缓解率(OMRR)和完全代谢缓解率(CMRR)、无进展生存期(PFS)、缓解持续时间、安全性和耐受性,以及健康相关生活质量。中位随访 15.3 个月(95% 置信区间[CI]10.1–17.7)后,研究达到主要终点,OS 中位数为 14.7 个月(90% CI 8.8 个月至未达到)。最佳 OMRR 为 76.1%,最佳 CMRR 为 45.7%。PFS 中位数为 3.8 个月(95% CI 2.4–19.6)。尽管缩短了剂量递增流程,未观察到 CRS 或神经毒性事件增加;二者均无 3 级事件。总之,glofitamab 改善 CAR-T 治疗后 R/R DLBCL 参与者的 OS,且安全性特征良好。
Persons with diffuse large B cell lymphoma (DLBCL) refractory or in first progression/relapsed (R/R) after chimeric antigen receptor T (CAR-T) cell therapy exhibit dramatic outcomes. We enrolled such persons in a phase 2 single-arm, nonblinded trial ( NCT04703686 ) to evaluate the efficacy and safety of glofitamab, a CD20-CD3 T cell-engaging bispecific antibody, using a short ramp-up regimen to reach full dose within 1 week. A total of 46 participants received at least one glofitamab infusion following obinutuzumab (anti-CD20 monoclonal antibody) pretreatment. The primary endpoint was overall survival (OS). Secondary endpoints included independent-assessed best overall metabolic response rate (OMRR) and complete metabolic response rate (CMRR), progression-free survival (PFS), duration of response, safety and tolerability and health-related quality of life. After a median follow-up of 15.3 months (95% confidence interval (CI), 10.1-17.7), the primary endpoint was met, achieving a median OS of 14.7 months (90% CI, 8.8-not reached). The best OMRR was 76.1%. The best CMRR was 45.7%. The median PFS was 3.8 months (95% CI, 2.4-19.6). Despite the shortened setup dosing, no excess cytokine release syndrome or neurotoxicity events were observed (grade 3, 0% for both). In conclusion, glofitamab improved OS in participants with R/R DLBCL after CAR-T cell therapy, with a favorable safety profile.
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