泽布替尼与卡瑞利珠单抗联合 CD19 CAR-T 细胞治疗复发/难治性弥漫大 B 细胞淋巴瘤的疗效与安全性

To retrospectively analyze the efficacy and safety of zanubrutinib and camrelizumab combined with CD19 chimeric antigen receptor T-cell (CD19 CAR T-cell) in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL).

Thirty-six R/R DLBCL patients who received zanubrutinib and camrelizumab combined with CD19 CAR T-cell from January 2022 to June 2024 were selected in the combined group. Twenty R/R DLBCL patients who received only CD19 CART-cell were included in the non-combined group. The efficacy and safety of these two groups were observed and compared.

(1) The complete-response (CR) rates of the combined group after 1, 3, and 6 months were 61%, 75%, and 81%, respectively, while those of the non-combined group were 60%, 65%, and 60%, respectively. There were differences in CR rates at months 3 and 6 between the two groups ( P = 0.043, P = 0.006). Of the 10 patients who achieved partial response (PR) in the combined group at month 1, 7 achieved CR at month 6. (2) Median follow-up time was 24 months, and the 2-year progression-free survival (PFS) and overall-survival (OS) rates of the combined group were 64% and 72%, respectively, while those of the non-combined group were respectively 23% and 40%. The differences in 2-year PFS and OS between the two groups were statistically significant ( P< 0.001, P = 0.003). (3) There were no statistically significant differences in adverse events between the two groups. (4) The median expansion time of CAR T-cell in the combined group was 89 days (21-482), significantly longer than that in the non-combined group (42 days, 11-251), and the difference was statistically significant ( P= 0.015).

Zanubrutinib and camrelizumab may enhance the efficacy of CAR T-cell therapy in R/R DLBCL with a manageable safety. The combined therapy prolongs the expansion time of CAR T-cell.