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

J 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.

Basic information

Original name

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

Authors

SYKOROVA, Alice (203 Czech Republic), František FOLBER (203 Czech Republic, belonging to the institution), Kamila POLGAROVA (203 Czech Republic), Heidi MOCIKOVA (203 Czech Republic), Juraj DURAS (203 Czech Republic), Katerina STEINEROVA (203 Czech Republic), Ales OBR (203 Czech Republic), Adriana HEINDORFER (203 Czech Republic), Miriam LADICKA (203 Czech Republic), Lubica LUKACOVA (203 Czech Republic), Erika CELLAROVA (203 Czech Republic), Ivana PLAMENOVA (203 Czech Republic), David BELADA (203 Czech Republic), Andrea JANÍKOVÁ (203 Czech Republic, belonging to the institution), Marek TRNENY (203 Czech Republic), Tereza JANCARKOVA (203 Czech Republic), Vit PROCHAZKA (203 Czech Republic), Andrej VRANOVSKY (203 Czech Republic), Margareta KRALIKOVA (203 Czech Republic), Jan VYDRA (203 Czech Republic), Lukas SMOLEJ (203 Czech Republic), Lubos DRGONA (203 Czech Republic), Martin SEDMINA (203 Czech Republic), Eva CERMAKOVA (203 Czech Republic) and Robert PYTLIK (203 Czech Republic)

Edition

Cancer Medicine, Hoboken, Wiley, 2024, 2045-7634

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30205 Hematology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.000 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1002/cam4.70138

UT WoS

001308743500001

Keywords in English

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

Abstract

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).

Citovat

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 and 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. Cancer Medicine. Hoboken: Wiley, 2024, vol. 13, No 17, p. 1-15. ISSN 2045-7634. Available from: https://dx.doi.org/10.1002/cam4.70138.

@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 and 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, vol.~13, No~17, p.~1-15. ISSN~2045-7634. Available from: https://dx.doi.org/10.1002/cam4.70138.

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