Chimeric antigen receptor‐T cell therapy shows similar efficacy and toxicity in patients with diffuse large B‐cell lymphoma aged 70 and older compared to younger patients: A multicenter cohort study

oleh: Philipp Berning, Evgenii Shumilov, Markus Maulhardt, Hristo Boyadzhiev, Andrea Kerkhoff, Simon Call, Christian Reicherts, Anna O. Saidy, Enver Aydilek, Michèle Hoffmann, Urban Novak, Michael Daskalakis, Norbert Schmitz, Matthias Stelljes, Gerald Wulf, Ulrike Bacher, Georg Lenz, Thomas Pabst

Format: Article
Diterbitkan: Wiley 2024-03-01

Deskripsi

Abstract CD19‐directed chimeric antigen receptor (CAR)‐T cell therapy has become a standard treatment for relapsed/refractory diffuse large B‐cell lymphoma (r/r DLBCL). While the benefits of CAR‐T cell treatment are clear in the general patient population, there remains a relative scarcity of real‐world evidence regarding its efficacy and toxicity in patients (pts) aged ≥70 years with DLBCL. We conducted a multicenter retrospective analysis including 172 r/r DLBCL pts with CAR‐T cell treatment, axicabtagene ciloleucel or tisagenlecleucel, between 2019 and 2023 at three tertiary centers. Pts were grouped by age at CAR‐T infusion (<70 vs. ≥70 years). Subsequently, descriptive and survival analyses, including propensity score matching, were performed to compare outcomes between both age groups. We identified 109 pts aged <70 and 63 pts aged ≥70 years. Overall response rates for both age groups were comparable (77.7% vs. 78.3%; p = 0.63). With a median follow‐up of 8.3 months, median progression‐free survival was 10.2 months (95% confidence interval [CI]: 6.5–21.8) and 11.1 months (95% CI: 4.9–NR) (p = 0.93) for both cohorts. Median overall survival reached 21.8 months (95% CI: 11.8–NR) and 34.4 months (95% CI: 10.1–NR) (p = 0.97), respectively. No significant differences in the incidence of cytokine release syndrome (p = 0.53) or grade ≥3 neurotoxicity (p = 0.56) were observed. Relapse and nonrelapse mortality were not significantly different between both groups. Our findings provide additional support that CAR‐T cell therapy is feasible and effective in patients with r/r DLBCL aged 70 years or older, demonstrating outcomes comparable to those observed in younger patients. CAR‐T cell therapy should be not withheld for elderly patients with r/r DLBCL.