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@article{2436038, author = {Sykorova, Alice and Folber, František and Polgarova, Kamila and Mocikova, Heidi and Duras, Juraj and Steinerova, Katerina and Obr, Ales and Heindorfer, Adriana and Ladicka, Miriam and Lukacova, Lubica and Cellarova, Erika and Plamenova, Ivana and Belada, David and Janíková, Andrea and Trneny, Marek and Jancarkova, Tereza and Prochazka, Vit and Vranovsky, Andrej and Kralikova, Margareta and Vydra, Jan and Smolej, Lukas and Drgona, Lubos and Sedmina, Martin and Cermakova, Eva and Pytlik, Robert}, article_location = {Hoboken}, article_number = {17}, doi = {http://dx.doi.org/10.1002/cam4.70138}, keywords = {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}, language = {eng}, issn = {2045-7634}, journal = {Cancer Medicine}, title = {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}, url = {https://onlinelibrary.wiley.com/doi/10.1002/cam4.70138}, volume = {13}, year = {2024} }
TY - JOUR ID - 2436038 AU - Sykorova, Alice - Folber, František - Polgarova, Kamila - Mocikova, Heidi - Duras, Juraj - Steinerova, Katerina - Obr, Ales - Heindorfer, Adriana - Ladicka, Miriam - Lukacova, Lubica - Cellarova, Erika - Plamenova, Ivana - Belada, David - Janíková, Andrea - Trneny, Marek - Jancarkova, Tereza - Prochazka, Vit - Vranovsky, Andrej - Kralikova, Margareta - Vydra, Jan - Smolej, Lukas - Drgona, Lubos - Sedmina, Martin - Cermakova, Eva - Pytlik, Robert PY - 2024 TI - 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 JF - Cancer Medicine VL - 13 IS - 17 SP - 1-15 EP - 1-15 PB - Wiley SN - 20457634 KW - CAR T-cell failure KW - outcomes of patients after CAR T-cell therapy failure KW - relapsed/refractory large B-cell lymphoma KW - risk factors for CAR T-cell therapy failure UR - https://onlinelibrary.wiley.com/doi/10.1002/cam4.70138 N2 - 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). ER -
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. 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. \textit{Cancer Medicine}. Hoboken: Wiley, 2024, roč.~13, č.~17, s.~1-15. ISSN~2045-7634. Dostupné z: https://dx.doi.org/10.1002/cam4.70138.
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