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2024-10-09T15:03:25.000Z

Outcomes with tafasitamab + lenalidomide for LBCL pre- or post-CAR T-cell therapy

Oct 9, 2024
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Learning objective: After reading this article, learners will be able to cite a new clinical development in lymphoma.

To understand the effect of sequencing anti-CD19 therapy in the treatment of lymphoma, data from the DESCAR-T registry of adult patients in France with R/R LBCL were analyzed and outcomes in patients treated with tafasitamab + lenalidomide pre- or post-anti-CD19 CAR T-cell therapy (axi-cel or tisa-cel received in the third-line or later) were assessed.1 The results were published by Camus et al.1 in Blood Advances

Key learnings:

For patients with R/R LBCL who received tafasitamab + lenalidomide after progression with anti-CD19 CAR T-cell therapy, the median PFS, OS, and DOR after progression were 3, 4.7, and 8.1 months, respectively. 

Patients who received tafasitamab + lenalidomide for relapse >6 months after CAR T-cell infusion had better outcomes compared with those who received tafasitamab + lenalidomide <6 months after CAR T-cell infusion; median PFS was 5.6 vs 2 months, respectively (p = 0.0138), and median OS was not reached vs 3.8 months, respectively (p = 0.0034).

The efficacy of tafasitamab + lenalidomide post-CAR T-cell therapy was comparable to other salvage therapies; there was no significant difference in PFS and OS when comparing tafasitamab + lenalidomide to other treatment options or lenalidomide alone.

The number of patients who received tafasitamab + lenalidomide before CAR T-cell therapy was too low to determine its impact on post-CAR T-cell treatment outcomes.

This study confirms the poor prognosis for patients with LBCL who relapse after CAR T-cell therapy and highlights the need for alternative strategies for treating these patients, particularly for those relapsing early after CAR T-cell infusion. 

Further investigation into optimal treatment sequencing and timing for the treatment of LBCL is warranted, particularly to understand the clinical relevance of targeting CD19 in different lines of therapy.

Abbreviations: axi-cel, axicabtagene ciloleucel; CAR, chimeric antigen receptor; DOR, duration of response; LBCL, large B-cell lymphoma; liso-cel, lisocabtagene maraleucel; OS, overall survival; PFS, progression-free survival; R/R, relapsed/refractory.

  1. Camus V, Houot R, Brisou G, et al. Outcome of large B-cell lymphoma patients treated with tafasitamab plus lenalidomide either before or after CAR-T-cells. Blood Adv. Online ahead of print. DOI: 10.1182/bloodadvances.2024013726

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