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Sequencing immune-based therapies in B-cell malignancies
with Ulric Jäger, Sagar Lonial, and Krina Patel
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Patients with relapsed/refractory (R/R) primary central nervous system lymphoma (PCNSL) or secondary central nervous system lymphoma (SCNSL) have a dismal prognosis; as such, there is a need for novel treatment strategies for these patients.1 Several trials, including ZUMA-1 (NCT02348216) and JULIET (NCT02445248), have demonstrated the efficacy of anti-CD19 chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed/refractory large B-cell lymphoma1; however, there is a lack of data on the safety and efficacy of anti-CD19 CAR T-cell therapy in patients with PCNSL/SCNSL.1
During the 50th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), Ossami Saidy presented results from an analysis of CD19-targeted CAR T-cell therapy in patients with PCNSL or SCNSL from the EBMT and GoCART coalition.1 We summarize this presentation below.
A total of 95 patients with a median age of 62.6 years were included in this analysis. (Table 1).
Table 1. Patient characteristics*
Patient characteristics, % (unless otherwise specified) |
All patients (N = 95) |
Median age, years (range) |
62.6 (23–80) |
Aged >70 years |
25 |
Gender |
|
Male, n |
55 |
Female, n |
40 |
Type of CNS lymphoma |
|
PCNSL |
10.5 |
SCNSL |
89.5 |
ECOG Performance Status ≥2† |
22.6 |
Number of prior lines of therapy‡ |
|
1 |
5.8 |
2 |
30.4 |
≥3 |
63.8 |
Previously auto-HSCT§ |
32.3 |
Remission status at CAR T-cell infusion‖ |
|
Stable disease/progressive disease |
67.4 |
Partial remission |
24.7 |
Complete remission |
7.9 |
Auto-HSCT, autologous hematopoietic stem cell transplantation; CAR, chimeric antigen receptor; CNS, central nervous system; ECOG, Eastern Cooperative Oncology Group; PCNSL, primary central nervous system lymphoma; SCNSL, secondary CNSL. *Adapted from Ossami Saidy.1 |
Figure 1. 2-year survival rates in patients with PCNSL or SCNSL*
CR, complete remission; NRM, non-relapse mortality; OS, overall survival; PCNSL, primary central nervous system lymphoma; PD, progressive disease; PFS, progression-free survival; PR, partial remission; RI, relapse incidence; SCNSL, secondary central nervous system lymphoma; SD, stable disease.
*Data from Ossami Saidy1
After a median follow-up of 27 months, the incidence rates of immune effector cell-associated neurotoxicity syndrome at 3 and 15 days were 17% and 43%, respectively.
Key learnings |
|
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