CAR T cells for the long run in aggressive B-cell lymphoma
Mené sur 115 patients adultes atteints d'un lymphome à cellules B réfractaire aux traitements ou récidivant (durée médiane de suivi : 40,3 mois), cet essai international de phase II évalue l'efficacité, du point de vue du taux de réponse globale, et la sécurité du tisagenlecleucel
Since first being reported in 2010,1 CD19-directed chimeric antigen receptor (CAR) T cells have led a revolution in the treatment of B-cell non-Hodgkin lymphomas. The US Food and Drug Administration have approved three CAR T-cell products for the treatment of relapsed or refractory aggressive B-cell lymphomas: tisagenlecleucel, axicabtagene ciloleucel, and lisocabtagene maraleucel. All three showed high rates of complete responses in patients with refractory disease in pivotal trials (37 [40%] of 93,2 59 [58%] of 101,3 and 136 [53%] of 256,4 respectively), taking into account different patient selection and trial designs in each study. In parallel, real-world data have emerged for these products, showing similar overall responses of 61·8% (95% CI 53·6–69·6) for tisagenlecleucel and 70% (61–78) for axicabtagene ciloleucel, and complete responses in 60 (39%) of 152 patients for tisagenlecleucel and 61 (50%) of 122 patients for axicabtagene ciloleucel.5,6 Real-world studies have supported the efficacy and safety of CD19-directed CAR T-cell therapies, including in many patients who would not have been eligible for the pivotal clinical trials. Among patients treated with axicabtagene ciloleucel in the ZUMA-1 study7 with at least 4 years of follow-up (median follow-up 51·1 months), the median overall survival was 25·8 months, and the 4-year estimated overall survival was 44%. The reported duration of follow-up in the JULIET study was relatively short until now.
The Lancet Oncology , commentaire, 2020