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 (203 Česká republika), František FOLBER (203 Česká republika, domácí), Kamila POLGAROVA (203 Česká republika), Heidi MOCIKOVA (203 Česká republika), Juraj DURAS (203 Česká republika), Katerina STEINEROVA (203 Česká republika), Ales OBR (203 Česká republika), Adriana HEINDORFER (203 Česká republika), Miriam LADICKA (203 Česká republika), Lubica LUKACOVA (203 Česká republika), Erika CELLAROVA (203 Česká republika), Ivana PLAMENOVA (203 Česká republika), David BELADA (203 Česká republika), Andrea JANÍKOVÁ (203 Česká republika, domácí), Marek TRNENY (203 Česká republika), Tereza JANCARKOVA (203 Česká republika), Vit PROCHAZKA (203 Česká republika), Andrej VRANOVSKY (203 Česká republika), Margareta KRALIKOVA (203 Česká republika), Jan VYDRA (203 Česká republika), Lukas SMOLEJ (203 Česká republika), Lubos DRGONA (203 Česká republika), Martin SEDMINA (203 Česká republika), Eva CERMAKOVA (203 Česká republika) a Robert PYTLIK (203 Česká republika)
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: 4.000 v roce 2022
Organizační jednotka
Lékařská fakulta
UT WoS
001308743500001
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).