在CAR-T细胞疗法失败后,在不耐药或复发的扩散大B细胞淋巴瘤中使用glofitamab:一项2期LYSA研究
Guillaume Cartron1,2, Roch Houot3,4, Yassine Al Tabaa5
1Department of Hematology, University Hospital of Montpellier, Montpellier, France. g-cartron@chu-montpellier.fr.
Nature cancer
|April 3, 2025
概括
在CAR-T治疗后,glofitamab显著改善了复发或耐火性扩散大B细胞淋巴瘤患者的整体存活率. 这种双特异性抗体表现出良好的安全性,没有过度严重的细胞因子释放综合征或神经毒性.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 患者在CAR-T治疗后不耐药或复发,预后不好.
- 化学抗原受体T (CAR-T) 细胞疗法是标准治疗,但在CAR-T后进展的患者的结果仍然很差.
研究的目的:
- 评估CD20-CD3双特异性抗体glofitamab的疗效和安全性,在CAR-T治疗后复发/耐药 (R/R) DLBCL的患者中.
- 为了评估整体存活率 (OS),响应率,无进展存活率 (PFS) 和使用新型短时间升级剂量方案的安全性.
主要方法:
- 一个第二阶段,单臂,非盲目的试验 (NCT04703686) 招募了46名R/R DLBCL后CAR-T的参与者.
- 参与者接受了 glofitamab 在obinutuzumab 前期治疗后,并进行了为期1周的升级疗程.
- 主要终点是整体存活率;次要终点包括应答率 (OMRR,CMRR),PFS和安全性.
主要成果:
- 平均总生存时间为14.7个月 (90% CI,8.8-NR),平均随访时间为15.3个月.
- 最好的整体代谢反应率 (OMRR) 为76.1%,完整代谢反应率 (CMRR) 为45.7%.
- 没有观察到≥3级细胞因子释放综合征或神经毒性事件,这表明安全性概况有利.
结论:
- 在CAR-T治疗后,glofitamab在改善R/RDLBCL患者的整体存活率方面表现出显著的有效性.
- 短暂的升级剂量疗法被很好地容忍,没有过多的严重不良事件.
- 格洛菲他马布对这一具有挑战性的患者群体来说是一个有前途的治疗选择.
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