Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy for Richter Transformation: An International, Multicenter, Retrospective Study

Kittai, AS; Bond, D; Huang, Y; Bhat, SA; Blyth, E; Byrd, JC; Chavez, JC; Davids, MS; Dela Cruz, JP; Dowling, MR; Duffy, C; Ho, C; Jacobson, C; Jaglowski, S; Jain, N; Lin, KH; Miller, C; McCarthy, C; Omer, Z; Parry, E; Rai, M; Rogers, KA; Saha, A; Schachter, L; Scott, H; Senapati, J; Shadman, M; Siddiqi, T; Stephens, DM; Vanguru, V; Wierda, W; Woyach, JA; Thompson, PA

Author(s): Kittai, AS; Bond, D; Huang, Y; Bhat, SA; Blyth, E; Byrd, JC; Chavez, JC; Davids, MS; Dela Cruz, JP; Dowling, MR; Duffy, C; Ho, C; Jacobson, C; Jaglowski, S; Jain, N; Lin, KH; Miller, C; McCarthy, C; Omer, Z; Parry, E; Rai, M; Rogers, KA; Saha, A; Schachter, L; Scott, H; Senapati, J; Shadman, M; Siddiqi, T; Stephens, DM; Vanguru, V; Wierda, W; Woyach, JA; Thompson, PA;
Details: Publication Year 2024-06-10,Volume 42,Issue #17,Page 2071-2079
Journal Title: Journal of Clinical Oncology
Publication Type: Research article
Abstract: PURPOSE: Outcomes for Richter transformation (RT) are poor with current therapies. The efficacy and safety of anti-CD19 chimeric antigen receptor T-cell therapy (CAR-T) for RT are not established. METHODS: We performed an international multicenter retrospective study of patients with RT who received CAR-T. Patient, disease, and treatment characteristics were summarized using descriptive statistics, and modeling analyses were used to determine association with progression-free survival (PFS) and overall survival (OS). PFS and OS were estimated from the date of CAR-T infusion. RESULTS: Sixty-nine patients were identified. The median age at CAR-T infusion was 64 years (range, 27-80). Patients had a median of four (range, 1-15) previous lines of therapy for CLL and/or RT, including previous Bruton tyrosine kinase inhibitor and/or BCL2 inhibitor therapy in 58 (84%) patients. The CAR-T product administered was axicabtagene ciloleucel in 44 patients (64%), tisagenlecleucel in 17 patients (25%), lisocabtagene maraleucel in seven patients (10%), and brexucabtagene autoleucel in one patient (1%). Eleven patients (16%) and 25 patients (37%) experienced grade ≥3 cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, respectively. The overall response rate was 63%, with 46% attaining a complete response (CR). After a median follow-up of 24 months, the median PFS was 4.7 months (95% CI, 2.0 to 6.9); the 2-year PFS was 29% (95% CI, 18 to 41). The median OS was 8.5 months (95% CI, 5.1 to 25.4); the 2-year OS was 38% (95% CI, 26 to 50). The median duration of response was 27.6 months (95% CI, 14.5 to not reached) for patients achieving CR. CONCLUSION: CAR-T demonstrates clinical efficacy for patients with RT.
Publisher: American Society of Clinical Oncology
Keywords: Humans; Retrospective Studies; Male; Middle Aged; Aged; Adult; Female; *Antigens, CD19/therapeutic use/immunology; *Immunotherapy, Adoptive/adverse effects/methods; Aged, 80 and over; *Receptors, Chimeric Antigen/therapeutic use/immunology; Leukemia, Lymphocytic, Chronic, B-Cell/therapy/immunology/mortality; Progression-Free Survival
Department(s): Clinical Haematology
Publisher's Version: https://doi.org/10.1200/jco.24.00033
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-08-06 05:34:03

Last Modified: 2024-08-06 05:34:17