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:Efficacy of polatuzumab vedotin versus conventional chemotherapy in relapsed or refractory diffuse large B-cell lymphoma.
Efficacy of polatuzumab vedotin versus conventional chemotherapy in relapsed or refractory diffuse large B-cell lymphoma.
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复发/难治性弥漫大B细胞淋巴瘤(R/R DLBCL)预后较差,尤其是对于不适合自体干细胞移植或细胞免疫治疗的患者。本研究评估了维泊妥珠单抗联合利妥昔单抗和苯达莫司汀(PBR)方案与常规化疗相比,在R/R DLBCL患者中的有效性。在86例首次复发或原发难治性DLBCL患者中,32例在任何后续治疗线中接受了PBR,而54例仅接受了常规化疗。为了进行比较,从这54例中选取了32例基线匹配的患者,定义为常规化疗组。所有患者的中位总生存期(OS)为17.3个月(范围,1.5-85.7个月),PBR治疗组显示出显著改善的结局(中位OS 19.7 vs. 15.8个月,P = 0.025)。单因素和多因素分析确定PBR是OS的有利预后因素。在二线治疗中,接受PBR的患者中有41.2%为≥ 80岁,而接受挽救方案的患者中这一比例仅为11.1%。尽管年龄分布更偏大,PBR组仍显示出有利无进展生存期的趋势。这些结果表明,在R/R DLBCL患者中,PBR治疗比常规化疗更有效且耐受性更好。
Relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) has a poor prognosis, particularly in patients ineligible for autologous stem cell transplantation or cellular immunotherapy.
This study evaluated the effectiveness of polatuzumab vedotin combined with rituximab and bendamustine (PBR) therapy in comparison to conventional chemotherapy in patients with R/R DLBCL. Of 86 patients with first relapse or primary refractory DLBCL, 32 received PBR in any subsequent line, while 54 received conventional chemotherapy alone. For comparison, 32 baseline-matched patients were selected from these 54 and defined as the conventional chemotherapy group. The median overall survival (OS) for all patients was 17. 3 months (range, 1. 5-85.
7 months), with the PBR-treated group showing significantly improved outcomes (median OS 19. 7 vs. 15. 8 months, P = 0. 025). Univariate and multivariate analyses identified PBR as a favorable prognostic factor for OS. In the second-line setting, 41. 2% of patients who received PBR were ≥ 80 years, compared with just 11.
1% of those who received salvage regimens. Despite this older age distribution, the PBR group showed a trend toward favorable progression-free survival. These results suggest that PBR therapy is more effective and tolerable than conventional chemotherapy in patients with R/R DLBCL.
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