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ZUMA-7 中二线 axicabtagene ciloleucel 或标准治疗后后续抗淋巴瘤治疗的结果。

Outcomes of subsequent antilymphoma therapies after second-line axicabtagene ciloleucel or standard of care in ZUMA-7.

机构信息

Department of Medicine, Division of Medical Oncology, Washington University School of Medicine, St Louis, MO.

Banner MD Anderson Cancer Center, Gilbert, AZ.

出版信息

Blood Adv. 2024 Jun 11;8(11):2982-2990. doi: 10.1182/bloodadvances.2023011532.

Abstract

The optimal management of patients with relapsed/refractory large B-cell lymphoma (LBCL) after disease progression or lack of response to second-line (2L) therapy remains unclear. Here, we report outcomes among patients who received subsequent antilymphoma therapy per investigator discretion separately by their randomized 2L arm in ZUMA-7, namely axicabtagene ciloleucel (axi-cel) vs standard of care (SOC). Progression-free survival (PFS) and overall survival (OS) were calculated from 3L therapy initiation. In the SOC arm, 127 of 179 randomized patients (71%) received 3L therapy. Median PFS among those who received 3L cellular immunotherapy (n = 68) vs those who did not (n = 59) was 6.3 vs 1.9 months, respectively; median OS was 16.3 vs 9.5 months, respectively. In the axi-cel arm, 84 of 180 randomized patients (47%) received 3L therapy. Median PFS among those who received 3L chemotherapy (n = 60) vs cellular immunotherapy (n = 8) was 1.7 vs 3.5 months, respectively; median OS was 8.1 months vs not reached, respectively. Of the 60 patients who received 3L chemotherapy, 10 underwent stem cell transplantation (SCT) after salvage chemotherapy. Median PFS was 11.5 vs 1.6 months, and median OS was 17.5 vs 7.2 months for those who did vs did not reach SCT, respectively. Eight patients received 3L cellular immunotherapy after 2L axi-cel. Of these, 6 patients received subsequent SCT in any line; all 6 were alive at data cutoff. These findings help inform subsequent treatment choices after 2L therapy failure for relapsed/refractory LBCL. The trial was registered at www.clinicaltrials.gov as #NCT03391466.

摘要

对于二线(2L)治疗后疾病进展或无反应的复发/难治性大 B 细胞淋巴瘤(LBCL)患者,其最佳治疗管理仍不清楚。在这里,我们报告了 ZUMA-7 中根据随机 2L 臂,由研究者自行决定随后接受抗淋巴瘤治疗的患者的结局,即 axi-cel 与标准护理(SOC)。无进展生存期(PFS)和总生存期(OS)从 3L 治疗开始计算。在 SOC 组中,179 名随机患者中有 127 名(71%)接受了 3L 治疗。接受 3L 细胞免疫治疗(n=68)和未接受 3L 细胞免疫治疗(n=59)的患者的中位 PFS 分别为 6.3 个月和 1.9 个月;中位 OS 分别为 16.3 个月和 9.5 个月。在 axi-cel 组中,180 名随机患者中有 84 名(47%)接受了 3L 治疗。接受 3L 化疗(n=60)和细胞免疫治疗(n=8)的患者的中位 PFS 分别为 1.7 个月和 3.5 个月;中位 OS 分别为 8.1 个月和未达到,分别。在接受 3L 化疗的 60 名患者中,10 名患者在挽救性化疗后接受了干细胞移植(SCT)。SCT 的患者中位 PFS 为 11.5 个月,未接受 SCT 的患者中位 PFS 为 1.6 个月;SCT 的患者中位 OS 为 17.5 个月,未接受 SCT 的患者中位 OS 为 7.2 个月。8 名患者在接受 2L axi-cel 后接受了 3L 细胞免疫治疗。其中 6 名患者在任何一线治疗后接受了后续 SCT;所有 6 名患者在数据截止时均存活。这些发现有助于为二线治疗失败后的复发/难治性 LBCL 患者提供后续治疗选择。该试验在 www.clinicaltrials.gov 上注册,编号为 #NCT03391466。

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