The University of Texas MD Anderson Cancer Center, Houston, TX.
City of Hope National Medical Center, Duarte, CA.
J Clin Oncol. 2024 Apr 1;42(10):1146-1157. doi: 10.1200/JCO.23.02214. Epub 2023 Dec 10.
To report the primary analysis results from the mantle cell lymphoma (MCL) cohort of the phase I seamless design TRANSCEND NHL 001 (ClinicalTrials.gov identifier: NCT02631044) study.
Patients with relapsed/refractory (R/R) MCL after ≥two lines of previous therapy, including a Bruton tyrosine kinase inhibitor (BTKi), an alkylating agent, and a CD20-targeted agent, received lisocabtagene maraleucel (liso-cel) at a target dose level (DL) of 50 × 10 (DL1) or 100 × 10 (DL2) chimeric antigen receptor-positive T cells. Primary end points were adverse events (AEs), dose-limiting toxicities, and objective response rate (ORR) by independent review committee per Lugano criteria.
Of 104 leukapheresed patients, liso-cel was infused into 88. Median (range) number of previous lines of therapy was three (1-11) with 30% receiving ≥five previous lines of therapy, 73% of patients were age 65 years and older, 69% had refractory disease, 53% had BTKi refractory disease, 23% had mutation, and 8% had secondary CNS lymphoma. Median (range) on-study follow-up was 16.1 months (0.4-60.5). In the efficacy set (n = 83; DL1 + DL2), ORR was 83.1% (95% CI, 73.3 to 90.5) and complete response (CR) rate was 72.3% (95% CI, 61.4 to 81.6). Median duration of response was 15.7 months (95% CI, 6.2 to 24.0) and progression-free survival was 15.3 months (95% CI, 6.6 to 24.9). Most common grade ≥3 treatment-emergent AEs were neutropenia (56%), anemia (37.5%), and thrombocytopenia (25%). Cytokine release syndrome (CRS) was reported in 61% of patients (grade 3/4, 1%; grade 5, 0), neurologic events (NEs) in 31% (grade 3/4, 9%; grade 5, 0), grade ≥3 infections in 15%, and prolonged cytopenia in 40%.
Liso-cel demonstrated high CR rate and deep, durable responses with low incidence of grade ≥3 CRS, NE, and infections in patients with heavily pretreated R/R MCL, including those with high-risk, aggressive disease.
报告 Ⅰ 期无缝设计 TRANSCEND NHL 001(临床试验.gov 标识符:NCT02631044)研究中套细胞淋巴瘤(MCL)队列的初步分析结果。
接受≥两线先前治疗(包括 Bruton 酪氨酸激酶抑制剂(BTKi)、烷化剂和 CD20 靶向药物)后复发/难治(R/R)的 MCL 患者,按照目标剂量水平(DL)50×10^6(DL1)或 100×10^6(DL2)输注嵌合抗原受体阳性 T 细胞接受 lisocabtagene maraleucel(liso-cel)治疗。主要终点为独立审查委员会根据 Lugano 标准评估的不良事件(AE)、剂量限制毒性和客观缓解率(ORR)。
在 104 例白细胞分离患者中,88 例输注了 liso-cel。中位(范围)先前治疗线数为 3 线(1-11 线),30%的患者接受≥5 线先前治疗,73%的患者年龄≥65 岁,69%的患者疾病为难治性,53%的患者疾病对 BTKi 耐药,23%的患者有 突变,8%的患者患有继发性中枢神经系统淋巴瘤。中位(范围)研究随访时间为 16.1 个月(0.4-60.5 个月)。在疗效评估集(n=83;DL1+DL2)中,ORR 为 83.1%(95%CI,73.3-90.5),完全缓解(CR)率为 72.3%(95%CI,61.4-81.6)。中位缓解持续时间为 15.7 个月(95%CI,6.2-24.0),无进展生存期为 15.3 个月(95%CI,6.6-24.9)。最常见的≥3 级治疗相关不良事件为中性粒细胞减少(56%)、贫血(37.5%)和血小板减少(25%)。报告了 61%的患者发生细胞因子释放综合征(CRS)(3/4 级,1%;5 级,0),31%的患者发生神经事件(NE)(3/4 级,9%;5 级,0),15%的患者发生≥3 级感染,40%的患者出现持续细胞减少。
liso-cel 治疗复发/难治性套细胞淋巴瘤患者,包括高危、侵袭性疾病患者,具有较高的 CR 率和深度、持久的缓解,且 CRS、NE 和感染的发生率较低,≥3 级细胞减少发生率较高。