Bendamustine administration within 9 months of apheresis significantly reduced response rates and survival in patients with relapsed\/refractory large B-cell lymphoma:<\/p>\n
CD19-directed chimeric antigen receptor (CAR) T-cell therapy provides durable responses and a potential cure in approximately one third of patients with relapsed or refractory large B-cell lymphoma (R\/R LBCL). Although it is known that therapy with the lymphotoxic chemotherapy agent bendamustine, prior to autologous T-cell collection, can impair T-cell number and function, its impact on patient outcomes has not been systematically addressed.<\/p>\n
Investigators have now conducted a retrospective, multicenter study of 439 patients with R\/R LBCL who had received two or more previous lines of therapy and were infused with commercially available CD19-targeted CAR T cells (axicabtagene ciloleucel or tisagenlecleucel). Of these patients, 80 (18%) had received one or more cycles of bendamustine, including 42 who had been treated within 9 months of apheresis. At baseline, bendamustine-exposed patients, compared with bendamustine-naive patients, were older (66 vs. 61 years), had poorer performance status (1, 16% vs. 7%), were more heavily pretreated (2 previous lines of therapy, 71% vs. 28%), and were more likely to have transformed indolent B-cell lymphoma (45% vs. 15%).<\/p>\n
At apheresis, bendamustine-exposed patients, compared with bendamustine-naive patients, had a significantly poorer overall response rate (ORR; 53% vs. 72%; P0.01), shorter progression-free survival (PFS; 3.1 vs. 6.2 months; P0.04), and shorter overall survival (OS; 10.3 vs. 23.5 months; P0.01). For those who received bendamustine within 9 months of apheresis, ORR was even lower (40%), and PFS and OS were shorter (1.3 and 4.6 months, respectively). Bendamustine-exposed patients also had lower absolute lymphocyte counts, lower CD4+<\/sup> T-cell counts, and poorer CAR T-cell expansion, but had similar rates of cytokine release syndrome and immune-effector cell-associated neurotoxicity syndrome.<\/p>\n","protected":false},"excerpt":{"rendered":" Bendamustine administration within 9 months of apheresis significantly reduced response rates and survival in patients with relapsed\/refractory large B-cell lymphoma: CD19-directed chimeric antigen receptor (CAR) T-cell therapy provides durable responses and a potential cure in approximately one third of patients with relapsed or refractory large B-cell lymphoma (R\/R LBCL). Although it is known that therapy [\u2026]<\/p>\n","protected":false},"author":662,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-175530","post","type-post","status-publish","format-standard","hentry","category-biotech-medical"],"_links":{"self":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/175530","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/users\/662"}],"replies":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/comments?post=175530"}],"version-history":[{"count":0,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/175530\/revisions"}],"wp:attachment":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/media?parent=175530"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/categories?post=175530"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/tags?post=175530"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}