嵌合抗原受体（CAR）T 细胞疗法对比历史对照在复发/难治性侵袭性 B 细胞淋巴瘤患者中的比较效果：真实世界环境下的间接治疗比较

Single-arm studies demonstrate dramatic improvements in survival in patients with relapsed/refractory (R/R) aggressive B-cell lymphomas but with significant toxicities and at exceptionally high costs. The objective of this study was to evaluate the real-world health outcomes of aggressive B-cell lymphoma patients treated with publicly funded chimeric antigen receptor (CAR) T-cell therapy in Ontario, Canada, compared to historical controls.

We conducted a population-based retrospective cohort study among patients treated for R/R aggressive B-cell lymphoma in Ontario between January 2013 and June 2023. The cohort consisted of patients who received commercially available CAR T cells between 1 January 2019 and 30 June 2023 and historical controls who were treated with the standard of care between 1 January 2013 and 31 December 2018, before public funding for CAR T-cell treatments was available. Inverse probability of treatment weighting (IPTW) was used to balance patients' characteristics across the two groups.

The cohort included 314 CAR T-cell patients and 106 historical controls. The median follow-up time was 29. 6 months (95% confidence interval [CI]: 26. 1-33. 0), and the median overall survival was 15. 1 months (95% CI, 11. 1-26. 3) and 4. 8 months (95% CI, 3. 8-6. 4) for CAR T-cell-treated patients and historical controls (hazard ratio 0. 50, 95% CI 0. 38-0. 65) respectively. These results support the benefit of CAR T-cell treatment for patients with R/R aggressive B-cell lymphoma in routine clinical care.