医学
细胞因子释放综合征
内科学
耐火材料(行星科学)
嵌合抗原受体
淋巴瘤
回顾性队列研究
队列
人口
肿瘤科
临床试验
胃肠病学
免疫疗法
癌症
天体生物学
环境卫生
物理
作者
Aurélie Benoit,Marie-Hélène Bergeron Boies,Nicole Déry,Luciana Melo Garcia,Mélanie Simard,Mireille Poirier,Robert Delage,Barbara Lortal Canguilhem,Catherine Doyle,Jean-François Larouche,Félix Couture,Christopher J. Lemieux
标识
DOI:10.1016/j.clml.2022.12.015
摘要
Chimeric antigen receptor (CAR) T-cells are an important new third-line treatment option for large B-cell lymphoma (LBCL). The objective response rates in pivotal early phase clinical trials with CAR T-cells were very promising. The objective of this study was to describe the efficacy results obtained with CAR T-cells infusions in our institution and to compare the toxicities of our cohort with those of pivotal trials and studies conducted in a real-life setting.Efficacy and safety data were retrospectively collected from 25 patients with LBCL treated with CAR T-cells therapy at CHU de Québec-Université Laval. A literature search was then performed to identify other efficacy or safety data from a real-life setting.At 3 months post infusion, the objective response rate (ORR) in our population with tisagenlecleucel and axicabtagene-ciloleucel were 20% and 47%, respectively. Bulky disease was the only negative predictor of poor response at 3 months (0% vs. 53%, P = .03). Bulky disease was associated with a median PFS of 2 months compared to 5 months for non-bulky disease (P = .0009). Grade ≥ 3 hematological toxicities were greater in patients treated with axi-cel (60% vs. 20%, P = .048), without bone marrow involvement (55% vs. 0%, P =.046), without stage IV disease (72% vs. 21%, P =.02), with refractory disease (67% vs. 10%, P =.01) or having been affected by cytokine release syndrome (58% vs. 0%, P =.02).The poor response rate at 3 months after infusion in our cohort was influenced mainly by bulky disease. Further studies are needed to better characterize the loss of efficacy of CAR T-cells because the majority of patients will relapse over time.
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