KEY TAKEAWAYS
- The study aimed to investigate the impact of varying bridging strategies and remission statuses preceding CAR-T cell therapy on outcomes in R/R LBCL.
- Researchers noticed that prioritizing minimal tumor burden and suitable bridging regimens can enhance CAR-T therapy efficacy in LBCL; further investigation is ongoing.
Incorporating chimeric antigen receptor (CAR)-T cell therapy into relapsed or refractory large B-cell lymphoma (rr LBCL) treatment algorithms has yielded remarkable response rates and durable remissions, yet a substantial portion of patients experience progression or relapse. Variations in outcomes across treatment centers may be attributed to different bridging strategies and remission statuses preceding CAR-T cell therapy.
Farina Eigendorff and the team aimed to assess the significance of minimal tumor burden at the time of CAR-T initiation and to highlight the importance of suitable bridging regimens in optimizing treatment outcomes.
They performed an inclusive analysis of 29 consecutive adult patients who received tisagenlecleucel (tisa-cel) for rr LBCL from December 2019 to February 2023.
The median age of the patients was 63, with a median of 3 prior treatments. About 70% of patients were refractory to systemic therapy before CAR-T cell treatment. Following leukapheresis, 86% of patients received bridging therapy, primarily chemotherapy (52%) or combined modality therapy (32%). Radiotherapy was part of the bridging strategy in 44%, with moderately hypofractionated involved site RT (30.0 Gy/2.5 Gy) applied most frequently (64%).
Post-CAR-T infusion, the objective response rate at 30 days was 83%, with 55% achieving complete response. 12-month progression-free (PFS) and overall survival (OS) were 60% and 74%, respectively, with a median follow-up of 11.1 months for PFS and 17.9 months for OS. Factors significantly associated with PFS were chemotherapy sensitivity pre-leukapheresis and response to bridging.
The study concluded that emphasizing minimal tumor burden at CAR-T initiation is crucial, highlighting the necessity for appropriate bridging regimens. These findings advocate for conducting clinical trials and further real-world analyses to optimize CAR-T cell therapy outcomes by identifying the most effective bridging strategies.
The study received open-access funding from Projekt DEAL.
Source: https://pubmed.ncbi.nlm.nih.gov/38693452/
Eigendorff F, Filimonova I, Scholl S, et al. (2024). “Effective bridging strategies prior to infusion with tisagenlecleucel results in high response rates and long-term remission in relapsed/refractory large B-cell lymphoma: findings from a German monocentric study.” J Cancer Res Clin Oncol. 2024 May 1;150(5):224. doi: 10.1007/s00432-024-05765-8. PMID: 38693452; PMCID: PMC11062962.
