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Tafasitamab 联合来那度胺作为弥漫性大 B 细胞淋巴瘤的挽救治疗:来自 GELTAMO 的真实世界经验

英文原题:Tafasitamab plus lenalidomide as salvage therapy in diffuse large B-cell lymphoma: real-world experience from GELTAMO.

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Tafasitamab plus lenalidomide as salvage therapy in diffuse large B-cell lymphoma: real-world experience from GELTAMO.

PubMed 2025/10/14(内容时间) Blood Adv Q1 · IF 7.7(JCR 2025)

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中文摘要

复发/难治性弥漫大B细胞淋巴瘤(R/R DLBCL)的治疗仍然具有挑战性,尤其是对于不适合强化治疗或CAR-T 细胞治疗的患者。基于2期L-MIND试验结果,tafasitamab联合来那度胺(T/L)是一种有效的选择,尽管真实世界证据研究尚未一致证实这些结果。

我们旨在描述西班牙接受T/L治疗的R/R DLBCL的真实世界结局。共有99例患者接受了至少1剂tafasitamab(意向治疗[ITT]队列),其中83例完成了至少1个完整周期的T/L(疗效队列)。对于ITT和疗效队列,中位随访时间分别为19.2个月和21.6个月时,总缓解率分别为51%和61%(完全缓解[CR],35%和42%)。中位缓解持续时间未达到,达到CR的患者结局极佳。ITT和疗效队列的中位无进展生存期(PFS)分别为4.9个月和10.9个月,总生存期(OS)分别为12.2个月和21.8个月。年龄和累积疾病评定量表评分均未影响生存。首次/第二次复发时获得更好的PFS,但仅东部肿瘤协作组体能状态2至4分、双打击淋巴瘤以及既往治疗后疾病难治/进展者与更差的PFS独立相关。治疗总体耐受良好,毒性可控。来那度胺的相对剂量强度显著影响缓解、PFS和OS。

总之,T/L既耐受良好又有效,与年龄或合并症无关。我们的发现为T/L的真实世界应用提供了有价值的见解,并强化了其作为R/R DLBCL患者关键治疗选择的地位。

展开英文摘要原文

Relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) remains challenging to treat, especially in patients ineligible for intensive therapy or chimeric antigen receptor T cells. Tafasitamab plus lenalidomide (T/L) is an effective option based on the phase 2 L-MIND trial findings, although real-world evidence studies have not consistently confirmed these results.

We aimed to describe real-world outcomes of R/R DLBCL treated with T/L in Spain. A total of 99 patients received at least 1 dose of tafasitamab (intent-to-treat [ITT] cohort), with 83 completing at least 1 full cycle of T/L (efficacy cohort). Respectively for ITT and efficacy cohorts, at a median follow-up of 19. 2 and 21. 6 months, the overall response rate was 51% and 61% (complete response [CR], 35% and 42%). Median duration of response was not reached, and patients achieving a CR had excellent outcomes. The median progression-free survival (PFS) was 4. 9 and 10. 9 months, and overall survival (OS) was 12. 2 and 21.

8 months, respectively for both ITT and efficacy cohorts. Neither age nor cumulative illness rating score influenced survival. Better PFS was obtained in first/second relapse but only poor Eastern Cooperative Oncology Group performance status 2 to 4, double-hit lymphoma, and those with refractory/progressing disease after the previous therapy, were independently associated with worse PFS.

Treatment was generally well tolerated, with manageable toxicity. Relative dose intensity of lenalidomide significantly affected response, PFS, and OS. In summary, T/L is both well tolerated and effective, irrespective of age or comorbidities.

Our findings provide valuable insights into the real-world application of T/L and reinforce its role as a key treatment option for patients with R/R DLBCL.

论文信息

作者
Gutierrez A、Zeberio I、Peñalver FJ、Martinez-Barranco P、Perez S、Morillo D、Martin X、Nicolas C
第一作者单位
Department of Hematology, University Hospital Son Espases, IdISBa, Palma, Spain.Spain
通讯作者单位
Department of Hematology, Instituto Catalán de Oncologia Hospitalet, Universidad de Barcelona, Instituto de Investigación Biomédica de Bellvitge IDIBELL, Barcelona, Spain.Spain
文献类型
多中心研究 · 观察性研究
期刊
Blood advances2025 Oct 14
原文标识
PubMed 40668613 · DOI 10.1182/bloodadvances.2025016661