2024
Several factors that predict the outcome of large B-cell lymphoma patients who relapse/progress after chimeric antigen receptor (CAR) T-cell therapy can be identified before cell administration
SYKOROVA, Alice; František FOLBER; Kamila POLGAROVA; Heidi MOCIKOVA; Juraj DURAS et al.Základní údaje
Originální název
Several factors that predict the outcome of large B-cell lymphoma patients who relapse/progress after chimeric antigen receptor (CAR) T-cell therapy can be identified before cell administration
Autoři
SYKOROVA, Alice; František FOLBER; Kamila POLGAROVA; Heidi MOCIKOVA; Juraj DURAS; Katerina STEINEROVA; Ales OBR; Adriana HEINDORFER; Miriam LADICKA; Lubica LUKACOVA; Erika CELLAROVA; Ivana PLAMENOVA; David BELADA; Andrea JANÍKOVÁ; Marek TRNENY; Tereza JANCARKOVA; Vit PROCHAZKA; Andrej VRANOVSKY; Margareta KRALIKOVA; Jan VYDRA; Lukas SMOLEJ; Lubos DRGONA; Martin SEDMINA; Eva CERMAKOVA a Robert PYTLIK
Vydání
Cancer Medicine, Hoboken, Wiley, 2024, 2045-7634
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30205 Hematology
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 3.100
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/24:00137181
Organizační jednotka
Lékařská fakulta
UT WoS
EID Scopus
Klíčová slova anglicky
CAR T-cell failure; outcomes of patients after CAR T-cell therapy failure; relapsed/refractory large B-cell lymphoma; risk factors for CAR T-cell therapy failure
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 23. 9. 2024 12:45, Mgr. Tereza Miškechová
Anotace
V originále
Aim: The aim of this study was to analyse the outcomes of patients with large B-cell lymphoma (LBCL) treated with chimeric antigen receptor T-cell therapy (CAR-Tx), with a focus on outcomes after CAR T-cell failure, and to define the risk factors for rapid progression and further treatment. Methods: We analysed 107 patients with LBCL from the Czech Republic and Slovakia who were treated in >= 3rd-line with tisagenlecleucel or axicabtagene ciloleucel between 2019 and 2022. Results: The overall response rate (ORR) was 60%, with a 50% complete response (CR) rate. The median progression-free survival (PFS) and overall survival (OS) were 4.3 and 26.4 months, respectively. Sixty-three patients (59%) were refractory or relapsed after CAR-Tx. Of these patients, 39 received radiotherapy or systemic therapy, with an ORR of 22% (CR 8%). The median follow-up of surviving patients in whom treatment failed was 10.6 months. Several factors predicting further treatment administration and outcomes were present even before CAR-Tx. Risk factors for not receiving further therapy after CAR-Tx failure were high lactate dehydrogenase (LDH) levels before apheresis, extranodal involvement (EN), high ferritin levels before lymphodepletion (LD) and ECOG PS >1 at R/P. The median OS-2 (from R/P after CAR-Tx) was 6.7 months (6-month 57.9%) for treated patients and 0.4 months (6-month 4.2%) for untreated patients (p < 0.001). The median PFS-2 (from R/P after CAR-Tx) was 3.2 months (6-month 28.5%) for treated patients. The risk factors for a shorter PFS-2 (n = 39) included: CRP > limit of the normal range (LNR) before LD, albumin < LNR and ECOG PS > 1 at R/P. All these factors, together with LDH > LNR before LD and EN involvement at R/P, predicted OS-2 for treated patients. Conclusion: Our findings allow better stratification of CAR-Tx candidates and stress the need for a proactive approach (earlier restaging, intervention after partial remission achievement).