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TRANSCEND NHL 001 研究中接受乐西妥珠单抗治疗的复发/难治性大 B 细胞淋巴瘤患者的 2 年随访结果

Two-year follow-up of lisocabtagene maraleucel in relapsed or refractory large B-cell lymphoma in TRANSCEND NHL 001.

机构信息

Lymphoma Program, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA.

Memorial Sloan Kettering Cancer Center, New York, NY.

出版信息

Blood. 2024 Feb 1;143(5):404-416. doi: 10.1182/blood.2023020854.

Abstract

Lisocabtagene maraleucel (liso-cel) demonstrated significant efficacy with a manageable safety profile as third-line or later treatment for patients with relapsed or refractory (R/R) large B-cell lymphoma (LBCL) in the TRANSCEND NHL 001 study. Primary end points were adverse events (AEs), dose-limiting toxicities, and objective response rate (ORR) per independent review committee. Key secondary end points were complete response (CR) rate, duration of response (DOR), progression-free survival (PFS), and overall survival (OS). After 2-year follow-up, patients could enroll in a separate study assessing long-term (≤15 years) safety and OS. Liso-cel-treated patients (N = 270) had a median age of 63 years (range, 18-86 years) and a median of 3 prior lines (range, 1-8) of systemic therapy, and 181 of them (67%) had chemotherapy-refractory LBCL. Median follow-up was 19.9 months. In efficacy-evaluable patients (N = 257), the ORR was 73% and CR rate was 53%. The median (95% confidence interval) DOR, PFS, and OS were 23.1 (8.6 to not reached), 6.8 (3.3-12.7), and 27.3 months (16.2-45.6), respectively. Estimated 2-year DOR, PFS, and OS rates were 49.5%, 40.6%, and 50.5%, respectively. In the 90-day treatment-emergent period (N = 270), grade 3 to 4 cytokine release syndrome and neurological events occurred in 2% and 10% of patients, respectively. The most common grade ≥3 AEs in treatment-emergent and posttreatment-emergent periods, respectively, were neutropenia (60% and 7%) and anemia (37% and 6%). Liso-cel demonstrated durable remissions and a manageable safety profile with no new safety signals during the 2-year follow-up in patients with R/R LBCL. These trials were registered at www.ClinicalTrials.gov as #NCT02631044 and #NCT03435796.

摘要

利妥昔单抗注射用偶联剂(liso-cel)在 TRANSCEND NHL 001 研究中作为三线或三线以上治疗方案,用于治疗复发/难治性(R/R)大 B 细胞淋巴瘤(LBCL)患者,显示出显著的疗效和可控的安全性。主要终点为不良事件(AE)、剂量限制性毒性和独立审查委员会评估的客观缓解率(ORR)。关键次要终点为完全缓解(CR)率、缓解持续时间(DOR)、无进展生存期(PFS)和总生存期(OS)。在 2 年随访后,患者可入组评估长期(≤15 年)安全性和 OS 的单独研究。接受 liso-cel 治疗的患者(N=270)中位年龄为 63 岁(范围,18-86 岁),中位治疗线数为 3 线(范围,1-8 线),181 例(67%)为化疗难治性 LBCL。中位随访时间为 19.9 个月。在可评估疗效的患者(N=257)中,ORR 为 73%,CR 率为 53%。中位(95%置信区间)DOR、PFS 和 OS 分别为 23.1(8.6-未达到)、6.8(3.3-12.7)和 27.3 个月(16.2-45.6)。估计 2 年 DOR、PFS 和 OS 率分别为 49.5%、40.6%和 50.5%。在 90 天治疗期间(N=270),分别有 2%和 10%的患者发生 3-4 级细胞因子释放综合征和神经事件。在治疗期间和治疗后期间,分别最常见的≥3 级 AE 为中性粒细胞减少症(60%和 7%)和贫血症(37%和 6%)。在 R/R LBCL 患者中,在 2 年随访期间,liso-cel 显示出持久的缓解和可控的安全性,没有新的安全性信号。这些试验在 www.ClinicalTrials.gov 上注册,分别为 #NCT02631044 和 #NCT03435796。

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