Axicabtagene ciloleucel as second-line therapy in large B cell lymphoma ineligible for autologous stem cell transplantation: a phase 2 trial.


Journal

Nature medicine
ISSN: 1546-170X
Titre abrégé: Nat Med
Pays: United States
ID NLM: 9502015

Informations de publication

Date de publication:
10 2023
Historique:
received: 25 05 2023
accepted: 29 08 2023
medline: 23 10 2023
pubmed: 15 9 2023
entrez: 14 9 2023
Statut: ppublish

Résumé

Axicabtagene ciloleucel (axi-cel) demonstrated superior efficacy compared to standard of care as second-line therapy in patients with high-risk relapsed/refractory (R/R) large B cell lymphoma (LBCL) considered eligible for autologous stem cell transplantation (ASCT); however, in clinical practice, roughly half of patients with R/R LBCL are deemed unsuitable candidates for ASCT. The efficacy of axi-cel remains to be ascertained in transplant-ineligible patients. ALYCANTE, an open-label, phase 2 study, evaluated axi-cel as a second-line therapy in 62 patients with R/R LBCL who were considered ineligible for ASCT. The primary end point was investigator-assessed complete metabolic response at 3 months from the axi-cel infusion. Key secondary end points included progression-free survival, overall survival and safety. The study met its primary end point with a complete metabolic response of 71.0% (95% confidence interval, 58.1-81.8%) at 3 months. With a median follow-up of 12.0 months (range, 2.1-17.9), median progression-free survival was 11.8 months (95% confidence interval, 8.4-not reached) and overall survival was not reached. There was no unexpected toxicity. Grade 3-4 cytokine release syndrome and neurologic events occurred in 8.1% and 14.5% of patients, respectively. These results support axi-cel as second-line therapy in patients with R/R LBCL ineligible for ASCT. ClinicalTrials.gov Identifier: NCT04531046 .

Identifiants

pubmed: 37710005
doi: 10.1038/s41591-023-02572-5
pii: 10.1038/s41591-023-02572-5
pmc: PMC10579056
doi:

Substances chimiques

axicabtagene ciloleucel U2I8T43Y7R
Biological Products 0
Antigens, CD19 0

Banques de données

ClinicalTrials.gov
['NCT04531046']

Types de publication

Clinical Trial, Phase II Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2593-2601

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2023. The Author(s).

Références

Lancet Haematol. 2022 May;9(5):e327-e339
pubmed: 35366963
Blood. 2022 May 5;139(18):2737-2746
pubmed: 35240677
Blood Adv. 2023 Sep 12;7(17):4926-4935
pubmed: 37067952
J Clin Oncol. 2014 Sep 20;32(27):3059-68
pubmed: 25113753
Biol Blood Marrow Transplant. 2015 Aug;21(8):1479-87
pubmed: 25862591
N Engl J Med. 2022 Dec 15;387(24):2220-2231
pubmed: 36507690
Blood. 2022 Jul 28;140(4):349-358
pubmed: 35316325
Lancet. 2022 Jun 18;399(10343):2294-2308
pubmed: 35717989
Biol Blood Marrow Transplant. 2019 Apr;25(4):625-638
pubmed: 30592986
Lancet. 2021 Sep 25;398(10306):1157-1169
pubmed: 34508654
Blood Adv. 2020 Nov 24;4(22):5607-5615
pubmed: 33180899
J Clin Oncol. 2021 Jun 20;39(18):1959-1970
pubmed: 33739857
J Clin Oncol. 2022 Feb 10;40(5):481-491
pubmed: 34914545
Haematologica. 2023 Jan 01;108(1):171-180
pubmed: 35678029
Biol Blood Marrow Transplant. 2017 Oct;23(10):1646-1650
pubmed: 28669923
Leuk Lymphoma. 2021 Sep;62(9):2161-2168
pubmed: 33764240
Transplant Cell Ther. 2022 Sep;28(9):581.e1-581.e8
pubmed: 35609867
J Clin Oncol. 2020 Sep 20;38(27):3119-3128
pubmed: 32401634
Clin Lymphoma Myeloma Leuk. 2023 Oct;23(10):757-763
pubmed: 37453865
Nat Med. 2022 Oct;28(10):2145-2154
pubmed: 36138152
Haematologica. 2022 May 01;107(5):1111-1118
pubmed: 34233446
Hematology Am Soc Hematol Educ Program. 2022 Dec 9;2022(1):146-154
pubmed: 36485076
Br J Haematol. 2023 Jul;202(1):65-73
pubmed: 37082780
J Clin Oncol. 2005 Jun 20;23(18):4117-26
pubmed: 15867204
J Clin Oncol. 2023 Apr 20;41(12):2238-2247
pubmed: 36548927
Blood. 2023 Apr 6;141(14):1675-1684
pubmed: 36542826
Leuk Lymphoma. 2019 Jul;60(7):1610-1625
pubmed: 30702000
N Engl J Med. 2023 Jul 13;389(2):148-157
pubmed: 37272527
Blood. 2020 Jun 4;135(23):2106-2109
pubmed: 32181801
Hemasphere. 2023 Jan 06;7(1):e817
pubmed: 36698613
Blood. 2005 Oct 15;106(8):2912-9
pubmed: 15994282
Lancet Oncol. 2022 Aug;23(8):1066-1077
pubmed: 35839786
J Clin Oncol. 2010 Sep 20;28(27):4184-90
pubmed: 20660832
Blood Adv. 2022 Jan 25;6(2):533-543
pubmed: 34749395
Eur J Cancer. 2022 Nov;175:246-253
pubmed: 36166850
Lancet Oncol. 2020 Jul;21(7):978-988
pubmed: 32511983
Lancet Oncol. 2006 May;7(5):379-91
pubmed: 16648042
N Engl J Med. 2022 Feb 17;386(7):640-654
pubmed: 34891224
Blood. 2016 May 19;127(20):2375-90
pubmed: 26980727
N Engl J Med. 2021 Mar 4;384(9):842-858
pubmed: 33657296
Ann Hematol. 2021 Sep;100(9):2303-2310
pubmed: 34236497
J Clin Oncol. 2017 Feb 10;35(5):544-551
pubmed: 28029326
J Clin Oncol. 2020 Jan 10;38(2):155-165
pubmed: 31693429
Haematologica. 2013 Nov;98(11):1726-31
pubmed: 23753028

Auteurs

Roch Houot (R)

Department of Hematology, University Hospital of Rennes, UMR U1236, INSERM, University of Rennes, French Blood Establishment, Rennes, France. roch.houot@chu-rennes.fr.

Emmanuel Bachy (E)

Department of Hematology, Lyon Sud Hospital Center, INSERM U1111, Lyon, France.

Guillaume Cartron (G)

Department of Hematology, University Hospital of Montpellier, UMR-CNRS 5535, Montpellier, France.

François-Xavier Gros (FX)

Department of Clinical Hematology and Cellular Therapy, University Hospital of Bordeaux, Bordeaux, France.

Franck Morschhauser (F)

ULR 7365 - GRITA, University Hospital of Lille, Lille, France.

Lucie Oberic (L)

Department of Hematology, Cancer University Institute of Toulouse Oncopole, Toulouse, France.

Thomas Gastinne (T)

Department of Hematology, University Hospital of Nantes, Nantes, France.

Pierre Feugier (P)

Department of Hematology, University Hospital of Nancy, INSERM 1256, University of Lorraine, Vandœuvre-lès-Nancy, France.

Rémy Duléry (R)

Department of Clinical Hematology and Cellular Therapy, Sorbonne University, Saint-Antoine Hospital, AP-HP, INSERM UMR938, Paris, France.

Catherine Thieblemont (C)

Department of Hematology and Oncology, Saint-Louis Hospital, AP-HP, Paris, France.

Magalie Joris (M)

Department of Hematology, University Hospital of Amiens, Amiens, France.

Fabrice Jardin (F)

Department of Clinical Hematology, Henri Becquerel Center, INSERM U1245, Rouen, France.

Sylvain Choquet (S)

Department of Hematology, University Hospital Pitié Salpêtrière, AP-HP, Sorbonne University, Paris, France.

Olivier Casasnovas (O)

Department of Clinical Hematology, Dijon University Hospital, INSERM UMR1231, Dijon, France.

Gabriel Brisou (G)

Department of Hematology, Institut Paoli-Calmettes, Marseille, France.

Morgane Cheminant (M)

Department of Clinical Hematology, Necker-Enfants Malades University Hospital, AP-HP, INSERM UMR1163, Paris, France.

Jacques-Olivier Bay (JO)

Department of Clinical Hematology and Cellular Therapy, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, France.

Francisco Llamas Gutierrez (FL)

Department of Anatomopathology, University Hospital of Rennes, Rennes, France.

Cédric Menard (C)

French Blood Establishment and SITI Laboratory, UMR U1236, INSERM, University of Rennes, University Hospital Center of Rennes, Rennes, France.

Karin Tarte (K)

French Blood Establishment and SITI Laboratory, UMR U1236, INSERM, University of Rennes, University Hospital Center of Rennes, Rennes, France.

Marie-Hélène Delfau (MH)

Department of Immunology, Henri Mondor Hospital, Créteil, France.

Cédric Portugues (C)

Department of Biostatistics, LYSARC, Lyon-Sud Hospital, Pierre-Bénite, France.

Emmanuel Itti (E)

Department of Nuclear Medicine, Henri Mondor Hospital, Créteil, France.

Xavier Palard-Novello (X)

Department of Nuclear Medicine, University of Rennes, CLCC Eugène Marquis, INSERM, Rennes, France.

Paul Blanc-Durand (P)

Department of Nuclear Medicine, CHU H. Mondor, U-PEC, AP-HP, Créteil, France.

Yassine Al Tabaa (Y)

Scintidoc Nuclear Medicine Center, Montpellier, France.

Clément Bailly (C)

Nantes-Angers Cancer Research Center CRCI2NA, University of Nantes, INSERM UMR1307, CNRS-ERL6075, Nantes, France.

Camille Laurent (C)

Department of Pathology, Cancer University Institute of Toulouse Oncopole, CHU Toulouse, CRCT INSERM U1037, Toulouse, France.

François Lemonnier (F)

Lymphoid Malignancies Unit, Henri Mondor Hospital, Mondor Institute for Biomedical Research, INSERM U955, University Paris-Est, Créteil, France.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH