Efficacy of chimeric antigen receptor T cell therapy and autologous stem cell transplant in relapsed or refractory diffuse large B-cell lymphoma: A systematic review

Tian, Linyan; Li, Cheng; Sun, Jun; Zhai, Yixin; Wang, Jinhuan; Liu, Su; Jiang, Yanan; Xing, Donghui; Lv, Yangyang; Guo, Jing; Xu, Hong; Sun, Huimeng; Li, Yuhang; Li, Lanfang; Zhao, Zhigang

doi:10.3389/fimmu.2022.1041177

Cited by 4 publications

(1 citation statement)

References 55 publications

(80 reference statements)

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“…The results of axi-cel therapy were published in the ZUMA-1 trial and comparing these results with the older SCHOLAR-1 trial demonstrated an overall survival benefit of an additional 20% at 2 years in the CAR-T arm [ 27 ]. These data strongly favor CAR-T therapy over autologous bone marrow transplantation, as was also investigated in a systematic meta-analysis showing the superiority of CAR-T [ 28 ]. However, the data presented in this paper outlines that a certain population of patients can still benefit from autologous transplantation, especially if CAR-T is not universally available.…”

Section: Discussionmentioning

confidence: 99%

Autologous Transplantation May Still Effectively Treat Relapsed Diffuse Large B-Cell Lymphoma in Selected Patients

Bicskó

Antal

Magyari

et al. 2023

Cancers

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Treating relapsed and refractory diffuse large B-cell lymphoma is still challenging for clinicians, but the available CAR-T and bispecific antibodies have revolutionized therapy. Autologous stem cell transplantation was the most effective treatment modality previously. The authors reported data from a single center over ten years. The retrospective study included 116 patients, with 53 relapsed cases, 39 primary refractory cases, 19 who had CNS involvement, and 5 who had received primary consolidation transplants. The median duration of follow-up was 46 months. The median event-free survival was 75 months, and the median overall survival was 105 months for all cases. Five-year overall survival was 59%, and event-free survival was 54%. Pretreatment prognostic factors at diagnosis had no effect on the outcome of transplantation. The authors found no difference between survival in relapsed or refractory cases, and the number of salvage lines or the germinal center/activated B-cell type also did not influence the results. Complete metabolic response before transplantation confirmed by 18FDG PET/CT strongly affected survival. The pre-transplant creatinine and CRP levels significantly influenced the long-term outcome. The number of stem cells infused did not affect survival, but engraftment within nine days did result in a longer survival. These data support the finding that the response to salvage therapy did facilitate the identification of a better prognostic group who may still benefit from autologous transplantation.

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Section: Discussionmentioning

confidence: 99%

Autologous Transplantation May Still Effectively Treat Relapsed Diffuse Large B-Cell Lymphoma in Selected Patients

Bicskó

Antal

Magyari

et al. 2023

Cancers

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Stem Cell Transplant for B Cell Non-Hodgkin Lymphoma

Sharma¹

2023

Basics of Hematopoietic Stem Cell Transplant

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Canadian cancer trials group LY.17: A randomized phase II study evaluating novel salvage therapy pre‐autologous stem cell transplant in relapsed/refractory diffuse large B‐cell lymphoma—outcome of rituximab‐dose‐intensive cyclophosphamide, etoposide, cisplatin (R‐DICEP) versus R‐GDP

Stewart,

Kuruvilla,

Lee

et al. 2024

Br J Haematol

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SummaryThe Canadian Cancer Trials Group (CCTG) LY.17 is an ongoing multi‐arm randomized phase II trial evaluating novel salvage therapies compared with R‐GDP (rituximab, gemcitabine, dexamethasone and cisplatin) in autologous stem cell transplantation (ASCT)‐eligible patients with relapsed/refractory diffuse large B‐cell lymphoma (RR‐DLBCL). This component of the LY.17 trial evaluated a dose‐intensive chemotherapy approach using a single cycle of inpatient R‐DICEP (rituximab, dose‐intensive cyclophosphamide, etoposide and cisplatin) to achieve both lymphoma response and stem cell mobilization, shortening time to ASCT. This report is the result of the protocol‐specified second interim analysis of the 67 patients who were randomized to either 1 cycle of R‐DICEP or to 3 cycles of R‐GDP. The overall response rate (ORR) was 65.6% for R‐DICEP and 48.6% for R‐GDP. The ASCT rate was 71.9% versus 54.3%, and 1‐year progression‐free survival rate was 42% versus 32%, respectively, for R‐DICEP versus R‐GDP. Although the improvement in ORR for R‐DICEP versus R‐GDP exceeded the pre‐specified 10% threshold to proceed to full accrual of 64 patients/arm, higher rates of grade 3–5 toxicities, and the need for hospitalization led to the decision to stop this arm of the study. CCTG LY.17 will continue to evaluate different salvage regimens that incorporate novel agents.

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Efficacy of chimeric antigen receptor T cell therapy and autologous stem cell transplant in relapsed or refractory diffuse large B-cell lymphoma: A systematic review

Cited by 4 publications

References 55 publications

Autologous Transplantation May Still Effectively Treat Relapsed Diffuse Large B-Cell Lymphoma in Selected Patients

Autologous Transplantation May Still Effectively Treat Relapsed Diffuse Large B-Cell Lymphoma in Selected Patients

Stem Cell Transplant for B Cell Non-Hodgkin Lymphoma

Canadian cancer trials group LY.17: A randomized phase II study evaluating novel salvage therapy pre‐autologous stem cell transplant in relapsed/refractory diffuse large B‐cell lymphoma—outcome of rituximab‐dose‐intensive cyclophosphamide, etoposide, cisplatin (R‐DICEP) versus R‐GDP

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