Two-year follow-up of KTE-X19 in patients with relapsed or refractory adult B-cell acute lymphoblastic leukemia in ZUMA-3 and its contextualization with SCHOLAR-3, an external historical control study.


Journal

Journal of hematology & oncology
ISSN: 1756-8722
Titre abrégé: J Hematol Oncol
Pays: England
ID NLM: 101468937

Informations de publication

Date de publication:
10 12 2022
Historique:
received: 04 08 2022
accepted: 05 10 2022
entrez: 9 12 2022
pubmed: 10 12 2022
medline: 15 12 2022
Statut: epublish

Résumé

Brexucabtagene autoleucel (KTE-X19) is an autologous anti-CD19 CAR T-cell therapy approved in the USA to treat adult patients with relapsed or refractory B-precursor acute lymphoblastic leukemia (R/R B-ALL) based on ZUMA-3 study results. We report updated ZUMA-3 outcomes with longer follow-up and an extended data set along with contextualization of outcomes to historical standard of care. Adults with R/R B-ALL received a single infusion of KTE-X19 (1 × 10 After 26.8-months median follow-up, the overall complete remission (CR) rate (CR + CR with incomplete hematological recovery) among treated patients (N = 55) in phase 2 was 71% (56% CR rate); medians for duration of remission and overall survival (OS) were 14.6 and 25.4 months, respectively. Most patients responded to KTE-X19 regardless of age or baseline bone marrow blast percentage, but less so in patients with > 75% blasts. No new safety signals were observed. Similar outcomes were observed in a pooled analysis of phase 1 and 2 patients (N = 78). In SCHOLAR-3, the median OS for treated patients from ZUMA-3 (N = 49) and matched historical controls (N = 40) was 25.4 and 5.5 months, respectively. These data, representing the longest follow-up of CAR T-cell therapy in a multicenter study of adult R/R B-ALL, suggest that KTE-X19 provides a clinically meaningful survival benefit with manageable toxicity in this population. NCT02614066.

Sections du résumé

BACKGROUND
Brexucabtagene autoleucel (KTE-X19) is an autologous anti-CD19 CAR T-cell therapy approved in the USA to treat adult patients with relapsed or refractory B-precursor acute lymphoblastic leukemia (R/R B-ALL) based on ZUMA-3 study results. We report updated ZUMA-3 outcomes with longer follow-up and an extended data set along with contextualization of outcomes to historical standard of care.
METHODS
Adults with R/R B-ALL received a single infusion of KTE-X19 (1 × 10
RESULTS
After 26.8-months median follow-up, the overall complete remission (CR) rate (CR + CR with incomplete hematological recovery) among treated patients (N = 55) in phase 2 was 71% (56% CR rate); medians for duration of remission and overall survival (OS) were 14.6 and 25.4 months, respectively. Most patients responded to KTE-X19 regardless of age or baseline bone marrow blast percentage, but less so in patients with > 75% blasts. No new safety signals were observed. Similar outcomes were observed in a pooled analysis of phase 1 and 2 patients (N = 78). In SCHOLAR-3, the median OS for treated patients from ZUMA-3 (N = 49) and matched historical controls (N = 40) was 25.4 and 5.5 months, respectively.
CONCLUSIONS
These data, representing the longest follow-up of CAR T-cell therapy in a multicenter study of adult R/R B-ALL, suggest that KTE-X19 provides a clinically meaningful survival benefit with manageable toxicity in this population.
TRIAL REGISTRATION
NCT02614066.

Identifiants

pubmed: 36494725
doi: 10.1186/s13045-022-01379-0
pii: 10.1186/s13045-022-01379-0
pmc: PMC9734710
doi:

Substances chimiques

Receptors, Chimeric Antigen 0
Antigens, CD19 0

Banques de données

ClinicalTrials.gov
['NCT02614066']

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

170

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States

Informations de copyright

© 2022. The Author(s).

Références

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pubmed: 33827116
Lancet. 2021 Aug 7;398(10299):491-502
pubmed: 34097852
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pubmed: 30920645
N Engl J Med. 2020 Apr 2;382(14):1331-1342
pubmed: 32242358
Lancet Oncol. 2019 Jan;20(1):31-42
pubmed: 30518502
Blood Cancer J. 2016 Sep 23;6(9):e473
pubmed: 27662202

Auteurs

Bijal D Shah (BD)

Moffitt Cancer Center, Tampa, FL, 33612, USA. bijal.shah@moffitt.org.

Armin Ghobadi (A)

Washington University School of Medicine, St Louis, MO, USA.

Olalekan O Oluwole (OO)

Vanderbilt University Cancer Center, Nashville, TN, USA.

Aaron C Logan (AC)

UCSF Medical Center, San Francisco, CA, USA.

Nicolas Boissel (N)

Hôpital Saint-Louis, Paris, France.

Ryan D Cassaday (RD)

University of Washington, Fred Hutchinson Cancer Center, Seattle, WA, USA.

Thibaut Leguay (T)

Service d'hématologie Clinique Et Thérapie Cellulaire, Hopital du Haut-Leveque CHU de Bordeaux, Bordeaux, France.

Michael R Bishop (MR)

The University of Chicago Medicine, Chicago, IL, USA.

Max S Topp (MS)

Medizinische Klinik Und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany.

Dimitrios Tzachanis (D)

University of California San Diego, San Diego, CA, USA.

Kristen M O'Dwyer (KM)

Wilmot Cancer Institute of University of Rochester, Rochester, NY, USA.

Martha L Arellano (ML)

Winship Cancer Institute of Emory University, Atlanta, GA, USA.

Yi Lin (Y)

Mayo Clinic, Rochester, MN, USA.

Maria R Baer (MR)

University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.

Gary J Schiller (GJ)

David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Jae H Park (JH)

Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Marion Subklewe (M)

Ludwig-Maximilians-Universität München, Munich, Germany.

Mehrdad Abedi (M)

University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA.

Monique C Minnema (MC)

University Medical Center Utrecht (on behalf of HOVON/LLPC), Utrecht, The Netherlands.

William G Wierda (WG)

The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Daniel J DeAngelo (DJ)

Dana-Farber Cancer Institute, Boston, MA, USA.

Patrick Stiff (P)

Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.

Deepa Jeyakumar (D)

University of California Irvine Medical Center, Orange, CA, USA.

Jinghui Dong (J)

Kite, a Gilead Company, Santa Monica, CA, USA.

Sabina Adhikary (S)

Kite, a Gilead Company, Santa Monica, CA, USA.

Lang Zhou (L)

Kite, a Gilead Company, Santa Monica, CA, USA.

Petra C Schuberth (PC)

Kite, a Gilead Company, Santa Monica, CA, USA.

Imi Faghmous (I)

Kite, a Gilead Company, Santa Monica, CA, USA.

Behzad Kharabi Masouleh (BK)

Kite, a Gilead Company, Santa Monica, CA, USA.

Roch Houot (R)

CHU Rennes, Univ Rennes, Inserm & EFS, Rennes, France.

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