Efficacy and safety analysis of the zanubrutinib-based bridging regimen in chimeric antigen receptor T-cell therapy for relapsed/refractory diffuse large B-cell lymphoma.
10.3760/cma.j.issn.0253-2727.2023.10.004
- Author:
Yan LU
1
;
Hui LIU
2
;
Shi Guang YE
1
;
Li Li ZHOU
1
;
Xiu LUO
1
;
Xiu Yong DANG
1
;
Xiang Gui YUAN
2
;
Wen Bin QIAN
2
;
Ai Bin LIANG
1
;
Ping LI
1
Author Information
1. Department of Hematology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
2. Department of Hematology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China.
- Publication Type:Journal Article
- Keywords:
Bridging treatment;
Chimeric antigen receptor T-cells;
Relapsed or refractory diffuse large B-cell lymphoma;
Zanubrutinib
- MeSH:
Humans;
Middle Aged;
Receptors, Chimeric Antigen/therapeutic use*;
Retrospective Studies;
Immunotherapy, Adoptive/adverse effects*;
Lymphoma, Large B-Cell, Diffuse/drug therapy*;
Cell- and Tissue-Based Therapy;
Antigens, CD19/adverse effects*
- From:
Chinese Journal of Hematology
2023;44(10):813-819
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To further elucidate the clinical efficacy and safety of a combination regimen based on the BTK inhibitor zebutanil bridging CD19 Chimeric antigen receptor T cells (CAR-T cells) in the treatment of relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) . Methods: Twenty-one patients with high-risk r/r DLBCL were treated with a zanubrutinib-based regimen bridging CAR-T between June 2020 and June 2023 at the Department of Hematology, Tongji Hospital, Tongji University and the Second Affiliated Hospital of Zhejiang University, and the efficacy and safety were retrospectively analyzed. Results: All 21 patients were enrolled, and the median age was 57 years (range: 38-76). Fourteen patients (66.7%) had an eastern cooperative oncology group performance status score (ECOG score) of ≥2. Eighteen patients (85.7%) had an international prognostic index (IPI) score of ≥3. Three patients (14.3%) had an IPI score of 2 but had extranodal infiltration. Fourteen patients (66.7%) had double-expression of DLBCL and seven (33.3%) had TP53 mutations. With a median follow-up of 24.8 (95% CI 17.0-31.6) months, the objective response rate was 81.0%, and 11 patients (52.4%) achieved complete remission. The median progression-free survival (PFS) was 12.8 months, and the median overall survival (OS) was not reached. The 1-year PFS rate was 52.4% (95% CI 29.8% -74.3%), and the 1-year OS rate was 80.1% (95% CI 58.1% -94.6%). Moreover, 18 patients (85.7%) had grade 1-2 cytokine-release syndrome, and two patients (9.5%) had grade 1 immune effector cell-associated neurotoxicity syndrome. Conclusion: Zanubrutinib-based combination bridging regimen of CAR-T therapy for r/r DLBCL has high efficacy and demonstrated a good safety profile.
