Commercialanti-CD19 CART cell therapy for patients with relapsed/refractory aggressive B cell lymphoma in a European center
Por:
Sesques, P, Ferrant, E, Safar, V, Wallet, F, Tordo, J, Dhomps, A, Karlin, L, Brisou, G, Vercasson, M, Hospital-Gustem, C, Schwiertz, V, Ranchon, F, Rioufol, C, Choquet, M, Sujobert, P, Ghergus, D, Bouafia, F, Golfier, C, Lequeu, H, Lazareth, A, Novelli, S, Devic, P, Glehen, AT, Viel, S, Venet, F, Mialou, V, Hequet, O, Chauchet, A, Arkam, Y, Nicolas-Virelizier, E, Peyrade, F, Cavalieri, D, Ader, F, Ghesquieres, H, Salles, G, Bachy, E
Publicada:
1 nov 2020
Ahead of Print:
1 ago 2020
Resumen:
Two autologous anti-CD19 chimeric antigen receptors (CAR) T cells (axicabtagene ciloleucel [axi-cel] and tisagenlecleucel [tisa-cel]) are commercially approved in Europe for relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL). We performed a retrospective study to evaluate patterns of use, efficacy and safety for axi-cel and tisa-cel. Data from 70 patients who underwent apheresis for commercial CAR T cells between January 2018 and November 2019 in our institution were retrospectively collected. Sixty-one patients were infused. The median age at infusion was 59 years old (range 27-75 years). The median number of prior therapies was 3 (range, 2-6). The overall response rates (ORRs) at 1 month and 3 months were 63% and 45%, respectively, with 48% and 39% achieving a complete response (CR), respectively. After a median follow-up after infusion of 5.7 months, the median progression-free survival (PFS) was 3.0 months (95% CI, 2.8-8.8 months), and the median overall survival (OS) was 11.8 months (95% CI, 6.0-12.6 months). In multivariate analysis, factors associated with poor PFS were the number of previous lines of treatment before CAR T cells (>= 4) (P= .010) and a C reactive protein (CRP) value >30 mg/L at the time of lymphodepletion (P <.001). Likewise, the only factor associated with a shorter OS was CRP >30 mg/L (P= .009). Cytokine release syndrome (CRS) of any grade occurred in 85% of patients, including 8% of patients with CRS of grade 3 or higher. Immune cell-associated neurotoxicity syndrome (ICANS) of any grade occurred in 28% of patients, including 10% of patients with ICANS of grade 3 or higher. Regarding efficacy and safety, no significant difference was found between axi-cel and tisa-cel. This analysis describes one of the largest real-life cohorts of patients treated with axi-cel and tisa-cel for R/R aggressive B cell lymphoma in Europe.
Filiaciones:
Sesques, P:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Claude Bernard Lyon 1 Univ, Lyon, France
Ferrant, E:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Safar, V:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Wallet, F:
Lyon Sud Hosp, Dept Crit Care, Hosp Civils Lyon, Pierre Benite, France
Tordo, J:
Lyon Sud Hosp, Dept Nucl Med, Hosp Civils Lyon, Pierre Benite, France
Dhomps, A:
Lyon Sud Hosp, Dept Nucl Med, Hosp Civils Lyon, Pierre Benite, France
Karlin, L:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Brisou, G:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Claude Bernard Lyon 1 Univ, Lyon, France
Vercasson, M:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Hospital-Gustem, C:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Schwiertz, V:
Lyon Sud Hosp, Dept Pharm, Hosp Civils Lyon, Pierre Benite, France
Ranchon, F:
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Sud Hosp, Dept Pharm, Hosp Civils Lyon, Pierre Benite, France
Rioufol, C:
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Sud Hosp, Dept Pharm, Hosp Civils Lyon, Pierre Benite, France
Choquet, M:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Sujobert, P:
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Sud Hosp, Dept Hematol Lab, Hosp Civils Lyon, Pierre Benite, France
Lyon Canc Res Ctr, INSERM, U1052, Lyon, France
CNRS, UMR5286, Lyon, France
Ghergus, D:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Bouafia, F:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Golfier, C:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Claude Bernard Lyon 1 Univ, Lyon, France
Lequeu, H:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Lazareth, A:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Novelli, S:
Lyon Canc Res Ctr, INSERM, U1052, Lyon, France
CNRS, UMR5286, Lyon, France
Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain
Devic, P:
Lyon Sud Hosp, Dept Neurol, Hosp Civils Lyon, Pierre Benite, France
Glehen, AT:
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Canc Res Ctr, INSERM, U1052, Lyon, France
CNRS, UMR5286, Lyon, France
Lyon Sud Hosp, Dept Pathol, Hosp Civils Lyon, Pierre Benite, France
Viel, S:
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Sud Hosp, Dept Biol Immunol, Hosp Civils Lyon, Lyon, France
Int Ctr Res Infect Dis, INSERM, U1111, Lyon, France
CNRS, UMR5308, Lyon, France
Venet, F:
Claude Bernard Lyon 1 Univ, Lyon, France
Hop Edouard Herriot, Dept Clin Immunol, Hosp Civils Lyon, Lyon, France
Mialou, V:
Etab Francais Sang Auvergne Rhone Alpes, Dept Biol & Therapy, Decines Charpieu, France
Hequet, O:
Etab Francais Sang Auvergne Rhone Alpes, Dept Biol & Therapy, Decines Charpieu, France
Chauchet, A:
Besancon Univ Hosp, Dept Hematol, Besancon, France
Arkam, Y:
Hop Emile Muller, Dept Hematol, Mulhouse, France
Nicolas-Virelizier, E:
Ctr Leon Berard, Dept Hematol, Lyon, France
Peyrade, F:
Ctr Antoine Lacassagne, Dept Hematol, Nice, France
Cavalieri, D:
Clermont Ferrand Univ Hosp, Dept Hematol, Clermont Ferrand, France
Ader, F:
Croix Rousse Hosp, Dept Infect Dis, Hosp Civils Lyon, Lyon, France
Ghesquieres, H:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Canc Res Ctr, INSERM, U1052, Lyon, France
CNRS, UMR5286, Lyon, France
Salles, G:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Canc Res Ctr, INSERM, U1052, Lyon, France
CNRS, UMR5286, Lyon, France
Bachy, E:
Lyon Sud Hosp, Dept Hematol, Hosp Civils Lyon, Pierre Benite, France
Claude Bernard Lyon 1 Univ, Lyon, France
Lyon Canc Res Ctr, INSERM, U1052, Lyon, France
CNRS, UMR5286, Lyon, France
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