在接受第三线CAR T治疗的复发/耐药大B细胞淋巴瘤患者中,桥梁治疗的结果
Inna Y Gong1,2, Meenakshi Jeeva3, Katrina Hueniken4
1Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Hematological oncology
|March 3, 2026
概括
针对大型B细胞淋巴瘤的CAR T细胞疗法之前的桥梁疗法 (BT) 显示,与化疗相比,基于波拉图祖马布和放射治疗的方法改善了结果. 没有BT也表现出比化疗更好的结果,强调了需要优化策略的需要.
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:
- 化学抗原受体T细胞 (CAR T) 治疗是复发性/耐药性大B细胞淋巴瘤 (R/R LBCL) 的关键治疗方法.
- 桥梁疗法 (BT) 通常在CAR T输注之前进行,但最佳策略尚未明确.
- 评估不同的BT模式对于改善患者的治疗结果至关重要.
研究的目的:
- 评估各种桥梁治疗 (BT) 策略对接受CAR T治疗的R/R LBCL患者的反应和生存的影响.
- 为了比较化疗,以波拉图祖马布为基础的化疗,放射治疗,皮质类固醇和没有BT的疗效.
主要方法:
- 对219名R/R LBCL患者进行了第三线或之后的CD19导向CAR T治疗的回顾性分析.
- 比较BT方式,包括化疗,波拉图祖马布基化疗,放射治疗,皮质类固醇,和没有BT.
- 使用逻辑回归和Cox模型评估整体反应率 (ORR),无进展生存率 (PFS) 和整体生存率 (OS).
主要成果:
- 基于波拉图祖马布的BT (50%) 和放射治疗 (40%) 与化疗 (16%),相比,ORR更高.
- 包括所有活跃疾病的放射治疗显示出更高的ORR (51%) 与非综合性 (12%).
- 放射治疗 (47%) 和波拉图祖马布 (37%) 的两年PFS最高,而化疗BT与最高的2年淋巴瘤相关死亡率 (74%) 相关.
结论:
- 与传统化疗相比,基于波拉图祖马布的和放射治疗的BT,以及没有BT,与改善的反应和结果有关.
- 放射治疗和以波拉图祖马布为基础的BT在改善PFS和OS方面表现有前途.
- 需要进行进一步的前性研究,以建立最佳的,个性化的BT策略,用于接受CAR T治疗的R/R LBCL患者.
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