肿瘤细胞治疗研究
英文原题：Naïve CD4(+) T-cells and disease status at CART infusion correlate with clinical outcomes in real-world large B-cell lymphoma patients receiving second-line CAR T therapy.
在此，我们回顾性分析了 64 例接受二线商业化 axi-cel（n = 35）或 liso-cel（n = 29）治疗的患者。
Axicabtagene ciloleucel（axi-cel）和 lisocabtagene maraleucel（liso-cel）是复发或难治性大 B 细胞淋巴瘤二线标准治疗，但持久获益的临床和免疫学预测因素尚未明确。本研究回顾性分析 64 名接受商业化二线 axi-cel（n=35）或 liso-cel（n=29）治疗的患者。两种 CAR-T 产品的总缓解率（66%）和完全缓解率（55%）相近。24 个月无进展生存率和总生存率分别为 46% 和 76%。多变量分析显示，原发难治性疾病和输注时疾病进展与较低应答率相关。值得注意的是，毒性发生率相对较低，3% 患者发生 3–4 级细胞因子释放综合征（CRS）或免疫效应细胞相关神经毒性综合征（ICANS）。此外，单采时 CD4⁺ T 细胞计数较低与较差 PFS 相关。免疫表型分析显示，在接受 axi-cel 的患者中，单采时初始 CD4⁺ T 细胞计数较高可预测持久应答。更强 CAR-T 扩增、初始 CD8⁺CAR⁺ T 细胞富集，以及输注后第 7 天 PD-1 表达较低均与应答相关。因此，这些发现凸显二线 CAR-T 的疗效，并确定了与疾病和免疫状态相关的长期应答预测因素。
Axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel) are standard-of-care second-line therapies for relapsed or refractory large B-cell lymphomas, yet clinical and immunological predictors of durable benefit remain poorly defined. Here, we retrospectively analyze 64 patients treated with second-line commercial axi-cel (n = 35) or liso-cel (n = 29). Overall (66%) and complete (55%) response rates are similar between CART products. The 24-month progression-free survival (PFS) and overall survival rates are 46% and 76%, respectively. Primary refractory disease and progressive disease at infusion are associated with inferior response rates on multivariate analysis. Importantly, toxicity rate is relatively low, with 3% of patients experiencing Grade 3-4 cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Furthermore, lower CD4 + T-cell counts at apheresis correlate with inferior PFS. Immunophenotyping reveals that higher na ve CD4 + T-cell counts at apheresis predict durable response in axi-cel-treated patients. Greater CART expansion, enrichment for na ve CD8 + CAR + T-cells, and lower PD1 expression at day 7 post-infusion are associated with response. Thus, these findings highlight the efficacy of second-line CART and identify disease and immune-related predictors of long-term response.
MEMBER ACCOUNT
登录成功会直接打开下一页。
