Effective bridging therapy can improve CD19 CAR-T outcomes while maintaining safety in patients with large B-cell lymphoma
dc.contributor.author | Roddie, C. | |
dc.contributor.author | Neill, L. | |
dc.contributor.author | Osborne, W. | |
dc.contributor.author | Iyengar, S. | |
dc.contributor.author | Tholouli, E. | |
dc.contributor.author | Irvine, D. | |
dc.contributor.author | Chaganti, S. | |
dc.contributor.author | Besley, C. | |
dc.contributor.author | Bloor, Adrian | |
dc.contributor.author | Jones, C. H. | |
dc.contributor.author | Uttenthal, B. J. | |
dc.contributor.author | Johnson, R. J. | |
dc.contributor.author | Sanderson, R. | |
dc.contributor.author | Cheok, K. P. | |
dc.contributor.author | Marzolini, M. A. V. | |
dc.contributor.author | Townsend, W. M. | |
dc.contributor.author | O'Reilly, M. | |
dc.contributor.author | Kirkwood, A. A. | |
dc.contributor.author | Kuhnl, A. | |
dc.date.accessioned | 2023-02-23T15:17:21Z | |
dc.date.available | 2023-02-23T15:17:21Z | |
dc.date.issued | 2023 | en |
dc.identifier.citation | Roddie C, Neill L, Osborne W, Iyengar S, Tholouli E, Irvine D, et al. Effective bridging therapy can improve CD19 CAR-T outcomes while maintaining safety in patients with large B-cell lymphoma. Blood advances. 2023 Feb 1. PubMed PMID: 36724512. Epub 2023/02/02. eng. | en |
dc.identifier.pmid | 36724512 | en |
dc.identifier.doi | 10.1182/bloodadvances.2022009019 | en |
dc.identifier.uri | http://hdl.handle.net/10541/626034 | |
dc.description.abstract | The impact of bridging therapy (BT) on CD19-directed chimeric antigen receptor T-cell (CD19CAR-T) outcomes in large B-cell lymphoma (LBCL) is poorly characterised. Current practice is guided by physician preference rather than established evidence. Identification of effective BT modalities and factors predictive of response could improve CAR-T intention to treat and clinical outcomes. We assessed BT modality and response in 375 adult LBCL patients in relation to outcomes following axicabtagene ciloleucel (Axi-cel) or tisagenlecleucel (Tisa-cel). The majority of patients received BT with chemotherapy (57%) or radiotherapy (17%). We observed that BT was safe for patients, with minimal morbidity/mortality. We showed that complete or partial response to BT conferred a 42% reduction in disease progression and death following CD19CAR-T therapy. Multivariate analysis identified several factors associated with likelihood of response to BT, including response to last line therapy, the absence of bulky disease, and the use of Polatuzumab-containing chemotherapy regimens. Our data suggested that complete/partial response to BT may be more important for Tisa-cel than Axi-cel, as all Tisa-cel patients with less than partial response to BT experienced frank relapse within 12 months of CD19CAR-T infusion. In summary, BT in LBCL should be carefully planned towards optimal response and disease debulking, to improve CD19CAR-T patient outcomes. Polatuzumab-containing regimens should be strongly considered for all suitable patients, and failure to achieve complete/partial response to BT pre-Tisa-cel may prompt consideration of further lines of BT where possible. | en |
dc.language.iso | en | en |
dc.relation.url | https://dx.doi.org/10.1182/bloodadvances.2022009019 | en |
dc.title | Effective bridging therapy can improve CD19 CAR-T outcomes while maintaining safety in patients with large B-cell lymphoma | en |
dc.type | Article | en |
dc.contributor.department | UCL, London, United Kingdom | en |
dc.identifier.journal | Blood Advances | en |
dc.description.note | en] | |
refterms.dateFOA | 2023-03-06T12:58:33Z |