Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
ADC Therapeutics, New Providence, NJ, USA.
Blood Cancer J. 2024 Nov 28;14(1):210. doi: 10.1038/s41408-024-01195-4.
The efficacy of loncastuximab tesirine (lonca) following chimeric antigen receptor T-cell therapy (CAR-T) progression/failure is unknown. Hence, we sought to examine real-world use and outcomes of lonca following CAR-T in patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) in the USA. In this retrospective study, we included adults (age ≥ 18 years) with R/R DLBCL who received lonca monotherapy as third- (3 L) or fourth line (4 L) treatment after progressing on second line (2 L) or 3 L CAR-T, respectively. Post-CAR-T lonca outcomes included response rates (overall response rate [ORR] and complete response [CR] rate), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). A total of 118 patients were included in the analysis with 95 receiving lonca following 2 L CAR-T (median age:66 years; 61% male) and 23 following 3 L CAR-T (median age:57 years; 43% male). Patients with 2 L CAR-T/3 L lonca had an ORR of 73% (CR rate of 34%). With a median follow-up of 8.5 months following lonca initiation, median DOR, PFS, and OS were not reached. The DOR, PFS, and OS at 12 months were 68%, 77%, and 84%, respectively. Patients with 3 L CAR-T/4 L lonca had an ORR of 78% (CR rate of 17%). With a median follow-up of 13 months following lonca initiation, the median DOR and PFS were 7.6 and 12.0 months, while median OS was not reached. OS at 12 months was 95%. In this study, we found that lonca monotherapy was an effective treatment option in R/R DLBCL in 3 L and 4 L settings including those who were resistant to or progressed after CAR-T.
在嵌合抗原受体 T 细胞疗法 (CAR-T) 进展/失败后，loncastuximab tesirine（lonca）的疗效尚不清楚。因此，我们试图在美国研究复发/难治性（R/R）弥漫性大 B 细胞淋巴瘤（DLBCL）患者在接受 CAR-T 治疗后使用 lonca 的真实世界应用和结果。在这项回顾性研究中，我们纳入了接受 lonca 单药治疗的 R/R DLBCL 成年患者（年龄≥18 岁），这些患者在接受二线（2L）或三线（3L）CAR-T 治疗后进展，分别为三线（3L）或四线（4L）治疗。CAR-T 后 lonca 的结果包括缓解率（总缓解率 [ORR] 和完全缓解率 [CR]）、缓解持续时间（DOR）、无进展生存期（PFS）和总生存期（OS）。共纳入 118 例患者进行分析，其中 95 例患者在接受 2L CAR-T 后接受 lonca 治疗（中位年龄：66 岁；61%为男性），23 例患者在接受 3L CAR-T 后接受 lonca 治疗（中位年龄：57 岁；43%为男性）。接受 2L CAR-T/3L lonca 的患者 ORR 为 73%（CR 率为 34%）。在 lonca 起始后中位随访 8.5 个月时，中位 DOR、PFS 和 OS 均未达到。12 个月时的 DOR、PFS 和 OS 分别为 68%、77%和 84%。接受 3L CAR-T/4L lonca 的患者 ORR 为 78%（CR 率为 17%）。在 lonca 起始后中位随访 13 个月时，中位 DOR 和 PFS 分别为 7.6 个月和 12.0 个月，中位 OS 未达到。12 个月时的 OS 为 95%。在这项研究中，我们发现 lonca 单药治疗在 3L 和 4L 环境中是 R/R DLBCL 的一种有效治疗选择，包括对 CAR-T 耐药或进展的患者。
