Chimeric antigen receptor T-cell therapy yields similar outcomes in patients with and without cytokine release syndrome
© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved..
Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of many patients with aggressive relapsed or refractory large B-cell lymphoma (LBCL). Treatment can be complicated by clinically evident cytokine release syndrome (CRS), which is characterized by the development of fever, hypoxia, and hypotension, and can be life-threatening. Most patients treated with CAR-T cells develop CRS, which is thought to represent an immune phenomenon. It was previously unknown whether patients who did not develop CRS had reduced CAR-T cell activity and were therefore likely to have worse outcomes. We conducted a multicenter retrospective analysis of 352 adult patients treated at 8 academic medical centers in the United States who received axicabtagene ciloleucel or tisagenlecleucel for the treatment of LBCL. The outcomes of interest included progression-free survival, overall survival, complete response rate, and overall response rate. Of the included patients, 262 (74.4%) developed CRS. There was no significant difference in progression-free survival (P = .99) or overall survival (P = .16) between patients who developed CRS and those who did not develop CRS. Peak ferritin levels >5000 ng/mL during treatment and lactate dehydrogenase levels greater than the institutional upper limit of normal before lymphodepleting chemotherapy were associated with significantly worse progression-free and overall survival in the multivariate analysis. There was no significant difference in the complete response or overall response rates between patients who did and did not develop CRS. In this retrospective analysis, we report that patients who develop CRS have clinical outcomes similar to those of patients without CRS treated with commercial anti-CD19 CAR-T cells.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
Blood advances - 7(2023), 17 vom: 12. Sept., Seite 4765-4772 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bhaskar, Shakthi T [VerfasserIn] |
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| Links: |
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| Themen: |
Antigens, CD19 |
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| Anmerkungen: |
Date Completed 24.08.2023 Date Revised 27.02.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1182/bloodadvances.2022008937 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Bhaskar, Shakthi T |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Chimeric antigen receptor T-cell therapy yields similar outcomes in patients with and without cytokine release syndrome |
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| 520 | |a Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of many patients with aggressive relapsed or refractory large B-cell lymphoma (LBCL). Treatment can be complicated by clinically evident cytokine release syndrome (CRS), which is characterized by the development of fever, hypoxia, and hypotension, and can be life-threatening. Most patients treated with CAR-T cells develop CRS, which is thought to represent an immune phenomenon. It was previously unknown whether patients who did not develop CRS had reduced CAR-T cell activity and were therefore likely to have worse outcomes. We conducted a multicenter retrospective analysis of 352 adult patients treated at 8 academic medical centers in the United States who received axicabtagene ciloleucel or tisagenlecleucel for the treatment of LBCL. The outcomes of interest included progression-free survival, overall survival, complete response rate, and overall response rate. Of the included patients, 262 (74.4%) developed CRS. There was no significant difference in progression-free survival (P = .99) or overall survival (P = .16) between patients who developed CRS and those who did not develop CRS. Peak ferritin levels >5000 ng/mL during treatment and lactate dehydrogenase levels greater than the institutional upper limit of normal before lymphodepleting chemotherapy were associated with significantly worse progression-free and overall survival in the multivariate analysis. There was no significant difference in the complete response or overall response rates between patients who did and did not develop CRS. In this retrospective analysis, we report that patients who develop CRS have clinical outcomes similar to those of patients without CRS treated with commercial anti-CD19 CAR-T cells | ||
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| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Patel, Vivek G |e verfasserin |4 aut | |
| 700 | 1 | |a Porter, David L |e verfasserin |4 aut | |
| 700 | 1 | |a Schuster, Stephen J |e verfasserin |4 aut | |
| 700 | 1 | |a Nastoupil, Loretta J |e verfasserin |4 aut | |
| 700 | 1 | |a Perales, Miguel-Angel |e verfasserin |4 aut | |
| 700 | 1 | |a Tomas, Ana Alarcon |e verfasserin |4 aut | |
| 700 | 1 | |a Bishop, Michael R |e verfasserin |4 aut | |
| 700 | 1 | |a McGuirk, Joseph P |e verfasserin |4 aut | |
| 700 | 1 | |a Maziarz, Richard T |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Andy I |e verfasserin |4 aut | |
| 700 | 1 | |a Bachanova, Veronika |e verfasserin |4 aut | |
| 700 | 1 | |a Maakaron, Joseph E |e verfasserin |4 aut | |
| 700 | 1 | |a Riedell, Peter A |e verfasserin |4 aut | |
| 700 | 1 | |a Oluwole, Olalekan O |e verfasserin |4 aut | |
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