Abstract 339P
Background
The advent of chimeric antigen receptor T cell (CAR-T) therapy has improved the outcomes of many patients with diffuse large B-cell lymphoma (DLBCL). However, it remains unknown whether allogeneic stem cell transplantation (allo-SCT) or CAR-T therapy is better for patients with relapsed/refractory (r/r) DLBCL. We thus retrospectively analyzed the effects of both therapies on the outcomes of r/r DLBCL patients treated at a single institute.
Methods
The medical records of 47 patients treated with tisagenlecleucel (tisa-cel) and 25 who underwent allo-SCT between January 1 2000 and May 31 2023 at Okayama University Hospital were retrospectively reviewed. The primary endpoint was 1-year overall survival (OS). The secondary endpoints included 1-year progression-free survival (PFS), non-relapse mortality (NRM), and the response rate (complete or partial). Data on both groups were subjected to multivariate analysis. Disease was considered to be chemosensitive if at least a partial response was achieved, and chemorefractory if the disease was stable or progressed after the last course of chemotherapy.
Results
There were no between-group differences in age, sex, disease stage, the International Prognostic Index, the number of prior chemotherapies, or central nervous system or disease status. The 1-year OS and PFS of the tisa-cel group were significantly better than those of the allo-SCT group (62.3% vs. 20%; p = 0.0003, 47.3% vs. 12%, p = 0.01 respectively). No significant between-group differences in the response rate were observed (tisa-cel group 72% vs. allo-SCT group; 60%, p = 0.3). NRM was significantly lower in the tisa-cel group (no deaths vs. 46%, p = 0.00002). In multivariate analysis of all r/r DLBCL patients, tisa-cel was associated with a favorable 1-year OS (hazard ratio [HR] 0.32, range 0.17 to 0.61, p = 0.0004) and chemorefractory status was associated with a poor 1-year OS (HR 3.94, range 1.73 to 8.97, p = 0.001).
Conclusions
The OS and NRM of the tisa-cel group were significantly superior to those of the allo-SCT group. Thus, CAR-T therapy may be more effective and less toxic than allo-SCT in patients with r/r DLBCL.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
571P - Dacomitinib in treatment-naïve EGFR-mutant NSCLC patients with multiple brain metastases: Initial efficacy and safety data from a phase II study
Presenter: Yongfeng Yu
Session: Poster Display
Resources:
Abstract
572P - Multivariable five-year survival prediction model for prognosing patients with EGFR-mutated NSCLC treated with EGFR-TKIs
Presenter: Qi-An Wang
Session: Poster Display
Resources:
Abstract
573P - LUMINATE-103: Real-world treatment patterns and outcomes of patients (pts) with epidermal growth factor receptor mutant (EGFR MU), non-squamous (NSQ) locally advanced/metastatic non-small cell lung cancer (a/mNSCLC): Pooled analysis of large US electronic health record (EHR) datasets
Presenter: Byoung Chul Cho
Session: Poster Display
Resources:
Abstract
574P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC harboring uncommon EGFR mutations
Presenter: Lin Wu
Session: Poster Display
Resources:
Abstract
575P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC and brain metastasis: A multicenter cohort study
Presenter: Puyuan Xing
Session: Poster Display
Resources:
Abstract
576P - Clonality of both EGFR and co-occurring TP53 mutations affect the treatment efficacy of the third-generation EGFR-TKIs in advanced-stage EGFR-mutant non-small cell lung cancer
Presenter: Wen Feng Fang
Session: Poster Display
Resources:
Abstract
577P - A study of the efficacy and safety of amivantamab in EGFR exon 20 insertion (E20I) mutations in NSCLC
Presenter: Daeho Choi
Session: Poster Display
Resources:
Abstract
578P - Tyrosine kinase inhibitor treatment of elderly patients with epidermal growth factor receptor mutated advanced non-small cell lung cancer: A multi-institute retrospective study
Presenter: Ling-Jen Hung
Session: Poster Display
Resources:
Abstract
579P - Real-world study of dacomitinib as first-line treatment for patients with EGFR-mutant non-small cell lung cancer
Presenter: Ji Eun Shin
Session: Poster Display
Resources:
Abstract
580P - Efficacy and safety of dacomitinib as first-line treatment for advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor <italic>(EGFR)</italic> 21L858R mutation: A multicenter, ambispective, consecutive case-series study
Presenter: Shouzheng Wang
Session: Poster Display
Resources:
Abstract