Polatuzumab-based regimen or CAR T cell for patients with refractory/relapsed DLBCL—a matched cohort analysis

Irit Avivi, Chava Perry, Yafit Segman, Odelia Amit, Yaeli Bar-On, Ofrat Beyer Katz, Ronit Gold, Elena Ribakovsky, Abraham Avigdor, Vladimir Vainstein, Neta Goldschmidt, Shimrit Ringelstein-Harlev, Netanel A. Horowitz, Odit Gutwein, Ronit Gurion, Gilad Itchaki, Uri Abadi, Anatoly Nemets, Orit Sofer, Miri VezkerTamar Tadmor, Najib Dally, Kalman Filanovsky, Merav Leiba, Nadav Sarid, Noam Benyamini, Efrat Luttwak, Yair Herishanu, Ron Ram

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Polatuzumab (Pola)-based regimens and chimeric antigen receptor T (CAR T) cells provide superior outcome compared to conventional chemoimmunotherapy in patients with relapsed/refractory diffuse large B cell lymphoma (R/R DLBCL). Choosing between these strategies remains controversial. The efficacy of CAR T versus Pola-rituximab(R) /Pola-bendamustine(B)-R in R/R DLBCL patients after failing ≥2 lines of treatment was compared in a retrospective, ‘real-world’ study. Propensity score matching, for age, lymphoma category (de-novo/transformed), number of prior lines, Eastern Cooperative Oncology Group performance status and lactate dehydrogenase level, was applied to control for differences in patients’ characteristics. Response rate, progression-free survival (PFS) and overall survival (OS) were analyzed. A total of 82 patients, treated with CAR T (n=41) or Pola-based regimens (n=41), were included. No treatment-related deaths occurred with CAR T vs. 3 (7.3%) with Pola. The overall and complete response rates were 83% and 58% with CAR T vs. 66% and 44% with Pola-based-regimens (p=0.077 and p=0.18, respectively). At a median follow-up of 9 months (range 1–19.2) and 16 months (range 0.7–25.3) for the CAR T and Pola arm respectively, the median PFS has not been reached for CAR T vs. 5.6 months for Pola (95% CI 3.6–7.6, p=0.014). Median OS has not been reached for CAR T vs. 10.8 months (95% CI 2.2–19.4) for Pola (p=0.026). To conclude, in a real-world setting, treatment with CAR T achieved superior PFS and OS compared to Pola-based regimens in patients with R/R DLBCL.

Original languageEnglish
Pages (from-to)755-762
Number of pages8
JournalAnnals of Hematology
Volume101
Issue number4
DOIs
StatePublished - Apr 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords

  • CAR T
  • Relapsed/refractory DLBCL

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