Treatment outcomes in patients with large B-cell lymphoma after progression to chimeric antigen receptor T-cell therapy
Iacoboni, Gloria (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Iraola-Truchuelo, Josu (Hospital Universitari Vall d'Hebron. Institut de Recerca)
O'Reilly, Maeve (University College London Hospitals)
Navarro Garcés, Víctor (Vall d'Hebron Institut d'Oncologia)
Menne, Tobias (Freeman Hospital (Newcastle, Regne Unit))
Kwon, Mi (Hospital General Universitario Gregorio Marañón)
Martín-López, Ana África (Hospital Universitario de Salamanca)
Chaganti, Sridhar (Queen Elizabeth Hospital (Birmingham, Regne Unit))
Delgado, Javier (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Roddie, Claire (University College London Hospitals)
Pérez, Ariadna (Hospital Clínic Universitari (València))
Norman, Jane (Manchester Royal Infirmary)
Guerreiro, Manuel (Hospital Universitari i Politècnic La Fe (València))
Gibb, Adam (The Christie Hospital)
Caballero, Ana Carolina (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Besley, Caroline (University Hospitals Bristol and Weston)
Martínez-Cibrián, Nuria (Hospital Clínic i Provincial de Barcelona)
Mussetti, Alberto (Institut d'Investigació Biomèdica de Bellvitge)
Sanderson, Robin (King's College Hospital NHS Foundation Trust)
Luzardo, Hugo (Hospital Universitario de Gran Canaria Dr. Negrín)
Iyengar, Sunil (Royal Marsden Hospital (Regne Unit))
Sánchez, José María (Hospital Universitario 12 de Octubre (Madrid))
Jones, Ceri (University Hospital of Wales)
Sancho, Juan Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Barba, Pere (Vall d'Hebron Institut d'Oncologia)
Latif, Anne-Louise (Queen Elizabeth Hospital (Birmingham, Regne Unit))
López-Corral, Lucia (Hospital Universitario de Salamanca)
Hernani, Rafael (Hospital Clínic Universitari (València))
Reguera, Juan Luís (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Sureda, Anna (Institut d'Investigació Biomèdica de Bellvitge)
Garcia-Sancho, Alejandro Martin (Hospital Clínico Universitario (Salamanca))
Bastos, Mariana (Hospital General Universitario Gregorio Marañón)
Abrisqueta, Pau (Vall d'Hebron Institut d'Oncologia)
Kuhnl, Andrea (King's College Hospital NHS Foundation Trust)

Data:	2024
Resum:	Over 60% of relapsed/refractory (R/R) large B-cell lymphoma (LBCL) patients who receive chimeric antigen receptor (CAR) T cells will experience disease progression. There is no standard next line of therapy and information in this setting is scarce and heterogeneous. We analyzed 387 R/R LBCL patients who progressed after CAR T cells from July 2018 until March 2022 in Spain and the United Kingdom. Median overall survival (OS) was 5. 3 months, with significant differences according to the interval between infusion and progression (<2 months [1. 9 months], 2-6 months [5. 2 months], and >6 months [not reached]). After progression, 237 (61%) patients received treatment. Focusing on the first subsequent therapy, overall (complete) response rates were 67% (38%) for polatuzumab-bendamustine-rituximab (POLA), 51% (36%) for bispecific antibodies (BsAb), 45% (35%) for radiotherapy (RT), 33% (26%) for immune checkpoint inhibitors (ICIs), 25% (0%) for lenalidomide (LENA), and 25% (14%) for chemotherapy (CT). In terms of survival, 12-month progression-free survival and OS was 36. 2% and 51. 0% for POLA, 32. 0% and 50. 1% for BsAb, 30. 8% and 37. 5% for RT, 29. 9% and 27. 8% for ICI, 7. 3% and 20. 8% for LENA, and 6. 1% and 18. 3% for CT. Thirty-two (14%) patients received an allogeneic hematopoietic cell transplant with median OS not reached after a median follow-up of 15. 1 months. In conclusion, patients with R/R LBCL who progress within the first 2 months after CAR T-cell therapy have dismal outcomes. Novel targeted agents, such as polatuzumab and BsAbs, can achieve prolonged survival after CAR T-cell therapy failure.
Nota:	This research received no funding. The authors thank the GETH and GELTAMO collaborative Spanish groups, together with the UK National CAR-T Clinical Panel, for their support during the study development. Also, Angel Cedillo for his help with the database of this project.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	HemaSphere, Vol. 8 Núm. 5 (may 2024) , p. e62, ISSN 2572-9241

DOI: 10.1002/hem3.62
PMID: 38774657

11 p, 1.0 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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