Treatment strategies for patients with diffuse large B-cell lymphoma

Poletto, Stefano; Novo, Mattia; Paruzzo, Luca; Frascione, Pio Manlio Mirko; Vitolo, Umberto

doi:10.1016/j.ctrv.2022.102443

Cited by 63 publications

(42 citation statements)

References 86 publications

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“…remained in CR at 2 years of CAR T-cell infusion; that is, the remaining patients experienced disease progression and may benefit from further salvage treatment. 29 Current SOC therapy options include polatuzumab vedotin with bendamustine/rituximab, tafasitamab with rituximab, selinexor, loncastuximab tesirine, and conventional chemotherapy. 30 Bispecific antibodies (BsAbs) targeting CD20 and CD3 potentially have the most promising efficacy after failure of CART-cell therapy.…”

Section: Salvage Therapy For Relapse After Car T-cell Therapymentioning

confidence: 99%

“…As second‐line, third‐line, or later treatments, approximately 40% remained in CR at 2 years of CAR T‐cell infusion; that is, the remaining patients experienced disease progression and may benefit from further salvage treatment 29 . Current SOC therapy options include polatuzumab vedotin with bendamustine/rituximab, tafasitamab with rituximab, selinexor, loncastuximab tesirine, and conventional chemotherapy 30 .…”

Section: Salvage Therapy For Relapse After Car T‐cell Therapymentioning

confidence: 99%

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Current development of chimeric antigen receptor T‐cell therapy for diffuse large B‐cell lymphoma and high‐grade B‐cell lymphoma

Yamauchi,

Maruyama

2024

European J of Haematology

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Chimeric antigen receptor (CAR) T‐cell therapy has become a commercially available treatment option for relapsed or refractory (r/r) diffuse large B‐cell lymphoma (DLBCL) with two or more lines of prior therapies, and recently for high‐risk r/r DLBCL with one prior line of therapy. The successful development of CAR T‐cell therapy for multiple relapsed DLBCL has led to a boom in subsequent trials that investigated its utility in patients with other r/r B‐cell lymphoma subtypes. However, CAR T‐cell therapy is a multistep process that includes leukapheresis and manipulation which take several weeks. Therefore, patients with rapidly progressing or bulky disease may not be able to complete the therapeutic regimen involving CAR T‐cell products. This raises the question of the generalizability of the results of pivotal studies to the entire population. In this review, we summarize the development of CAR‐T cell therapy for B‐cell lymphoma and discuss strategies to further improve the clinical outcomes of this treatment.

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Section: Salvage Therapy For Relapse After Car T-cell Therapymentioning

confidence: 99%

Section: Salvage Therapy For Relapse After Car T‐cell Therapymentioning

confidence: 99%

Current development of chimeric antigen receptor T‐cell therapy for diffuse large B‐cell lymphoma and high‐grade B‐cell lymphoma

Yamauchi,

Maruyama

2024

European J of Haematology

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“…Allo-SCT represents a tool little used in R/R DLBCL patients, thanks to other recently approved therapeutic options, 3,10 but it could be still useful to consolidate the response in a multiple refractory patient, especially if young and fit. Two patients performed allo-SCT after pixantrone in our series.…”

Section: The Period Between Apheresis and Reinfusion Of Car T-cellsmentioning

confidence: 99%

Pixantrone as bridging therapy to allogeneic transplantation or in chimeric antigen receptor T‐cell pathway in patients with diffuse large B‐cell lymphoma

Lolli

Argnani

Gini

et al. 2023

Hematological Oncology

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“…In order to improve patients' response and quality of life, the treatment of the combination of CAR-T plus ASCT was rst reported in 2020 [6][7][8][9] . This treatment for patients with a low probability of long-term survival expected through simple autologous transplantation, or when poor post-transplant outcomes are anticipated based on certain risk factors, autologous transplantation combined with CAR-T therapy can be considered, such as: (1) patients with early relapse (r/r); (2) high International Prognostic Index (IPI) scores for lymphoma; (3) positive pre-transplant minimal residual disease (MRD) and PET/CT results; (4) presence of adverse genetics or molecular mutations; (5) lymphomas with immune-privileged organ involvement (PCNSL) [10] .…”

Section: Introductionmentioning

confidence: 99%

A Real-world cost-effectiveness study of autologous stem cell transplant plus CAR-T versus CAR-Ttherapy alone in Chinese patients with relapsed/refractory large B-cell lymphoma

Zhu,

Zhou,

Ruan

et al. 2024

Preprint

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This study aimed to evaluate the cost-effectiveness of autologous stem cell transplant plus CAR-T (ASCT + CAR-T) therapy compared to CAR-T therapy among relapsed/refractory large B-cell lymphoma (r/r LBCL) patients based on real-world data.Complete response rate (CR), adverse events (AE), and total treatment cost were identified and compared between the two therapy groups. Using a decision analytic model based on standard clinical flow, incremental cost-effectiveness ratios (ICERs) for overall survival were calculated with stratification by disease stage and hormone-receptor status. A total of 76 patients received CAR-T therapy and 81 underwent ASCT + CAR-T therapy. The average total treatment cost was ¥242,265.44 for the CAR-T group and ¥321,649.84 for the ASCT + CAR-T group (p < 0.001), 44.70% and 58.02% patients achieved CR at 6-month respectively (p = 0.1). Grade III or higher cytokine release syndrome events occurred in 6.8% of the CAR-T group and 13.6% of the ASCT + CAR-T group (p < 0.001). The ICER was ¥5,974.21 per 1% CR rate increase. The use of ASCT + CAR-T for r/r LBCL patients may lead to better effectiveness but also higher treatment costs. Commercial CAR-T demonstrated a higher CR rate but higher treatment costs compared to in-hospital CAR-T formulations. Our research provides support for the cost-effectiveness of different treatment option for r/r LBCL patients.

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Treatment strategies for patients with diffuse large B-cell lymphoma

Cited by 63 publications

References 86 publications

Current development of chimeric antigen receptor T‐cell therapy for diffuse large B‐cell lymphoma and high‐grade B‐cell lymphoma

Current development of chimeric antigen receptor T‐cell therapy for diffuse large B‐cell lymphoma and high‐grade B‐cell lymphoma

Pixantrone as bridging therapy to allogeneic transplantation or in chimeric antigen receptor T‐cell pathway in patients with diffuse large B‐cell lymphoma

A Real-world cost-effectiveness study of autologous stem cell transplant plus CAR-T versus CAR-Ttherapy alone in Chinese patients with relapsed/refractory large B-cell lymphoma

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