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:Health-related quality of life after second-line axi-cel in transplant-ineligible patients with large B-cell lymphoma.
Health-related quality of life after second-line axi-cel in transplant-ineligible patients with large B-cell lymphoma.
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2期ALYCANTE试验旨在评估高危复发/难治性大B细胞淋巴瘤且不适合自体干细胞移植(ASCT)的患者中,输注axicabtagene ciloleucel(axi-cel)后3个月时研究者评估的完全代谢缓解作为主要终点。
该研究显示,基于历史对照,3个月时完全代谢缓解率有显著改善。本研究报告作为次要终点的健康相关生活质量(HRQoL)结果。HRQoL采用欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)癌症特异性问卷、高级别非霍奇金淋巴瘤生活质量问卷29(QLQ-NHL-HG29)以及EuroQol生活质量量表-5维度-5严重程度水平(EQ-5D-5L)通用问卷,在基线以及axi-cel输注后1、3、6和12个月进行评估。在纳入的62例患者中,60例(97%)完成了基线及至少1次基线后HRQoL评估。输注后1个月时,HRQoL评分较基线的校正平均变化显示,躯体功能、角色功能、社会功能和疲乏出现具有临床意义的恶化(超过临床阈值)。
然而,所有HRQoL维度在输注后3个月时均恢复,并在12个月时保持稳定或继续改善。在一项探索性分析中,ALYCANTE中HRQoL评分较基线的校正平均变化与3期ZUMA-7试验中接受axi-cel且适合ASCT的患者相似或更好。
最后,ALYCANTE人群的总体健康状况和疲乏评分在输注后3个月时改善至与年龄相近的法国一般人群相当的水平。这些发现表明,无论是否符合移植条件,axi-cel均可改善HRQoL,支持其在广泛患者群体中的应用。该试验已在www.ClinicalTrials.gov注册,注册号为#NCT04531046。
The phase 2 ALYCANTE trial aimed to evaluate the investigator-assessed complete metabolic response at 3 months from the axicabtagene ciloleucel (axi-cel) infusion as a primary end point in patients with high-risk relapsed/refractory large B-cell lymphoma who are ineligible for autologous stem cell transplantation (ASCT).
This study showed a significant improvement in complete metabolic response rate at 3 months based on historical controls.
This study reports the health-related quality of life (HRQoL) results as a secondary end point. HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) cancer-specific questionnaire, the Quality of Life Questionnaire high-grade non-Hodgkin lymphoma 29 (QLQ-NHL-HG29) , and the EuroQol Quality of Life Scale-5 dimensions-5 levels of severity (EQ-5D-5L) generic questionnaire at baseline and 1, 3, 6, and 12 months after axi-cel infusion.
Among the 62 patients included, 60 (97%) completed a baseline and at least 1 postbaseline HRQoL assessment. At 1 month infusion, adjusted mean change in HRQoL scores from baseline showed a clinically significant deterioration (greater than the clinical threshold) in physical, role, social functioning, and fatigue.
However, all HRQoL dimensions recovered by 3 months after infusion and remained stable or continued to improve by 12 months. In an exploratory analysis, adjusted mean change in HRQoL score from baseline in ALYCANTE was similar to or better than in ASCT-eligible patients who received axi-cel in the phase 3 ZUMA-7 trial.
Finally, the global health status and fatigue scores of the ALYCANTE population improved to levels comparable to the general French population of similar age by 3 months after infusion.
These findings indicate that axi-cel improves HRQoL regardless of transplant eligibility, supporting its use across a broad patient population. This trial was registered at www. clinicaltrials. gov as #NCT04531046.
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