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. 2024 Oct 22;8(20):5371-5381.
doi: 10.1182/bloodadvances.2024013726.

Outcome of patients with large B-cell lymphoma treated with tafasitamab plus lenalidomide either before or after CAR T-cell therapy

Vincent Camus  1 , Roch Houot  2 , Gabriel Brisou  3 , Benoit Tessoulin  4 , Sébastien Bailly  5 , Pierre Sesques  6 , Justine Decroocq  7 , Daphné Krzisch  8 , Lucie Oberic  9 , François Lemonnier  10 , Krimo Bouabdallah  11 , Arnaud Campidelli  12 , Ledraa Tounes  13 , Julie Abraham  14 , Charles Herbaux  15 , Franck Morschhauser  16 , Gandhi Laurent Damaj  17 , Stéphanie Guidez  18 , Sylvain Carras  19 , Luc-Matthieu Fornecker  20 , Sylvain Choquet  21 , Olivier Hermine  22 , Jérome Paillassa  23 , Adrien Chauchet  24 , Olivier Casasnovas  25 , Laurianne Drieu La Rochelle  26 , Cristina Castilla-Llorente  27 , Magalie Joris  28 , Vivien Dupont  29 , Alexandra Marquet  29 , Steven Le Gouill  30 , Fabrice Jardin  1
Affiliations

Outcome of patients with large B-cell lymphoma treated with tafasitamab plus lenalidomide either before or after CAR T-cell therapy

Vincent Camus et al. Blood Adv. .

Abstract

Tafasitamab plus lenalidomide (TAFA-LEN) treatment relevance pre- or post-anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is debated. We analyzed patients with large B-cell lymphoma in the DESCAR-T registry treated with axi[1]cel or tisa-cel in ≥3rd line and TAFA-LEN before (n = 15, "TL-pre-CAR-T" set) or directly after (n = 52, "TL-post-CAR-T" set) CAR T-cell therapy. We compared TAFA-LEN v. other treatments using inverse probability weighting in the TL-post-CAR[1]T set. In the TL-post-CAR-T set, the median progression-free survival (mPFS), overall survival (mOS), and duration of response (mDOR) since the first treatment for progression (mPFS2/mOS2/mDOR2) were 3, 4.7, and 8.1 months, respectively. The best overall response rate (bORR) and best complete response rate (bCRR) after TAFA-LEN were 13.5% and 7.7%, respectively. Outcomes were better for patients who relapsed >6 months after CAR T-cell therapy (mPFS2: 5.6 vs 2 months, P = .0138; mOS2: not reached vs 3.8 months, P = .0034). The bORR and bCRR between TAFA-LEN and other treatments were 20.6% vs 24.9% and 11.6% vs 15.6%, respectively. Outcomes were similar between TAFA-LEN and other treatments (mPFS2: 2.9 vs 2.4 months, P = .91; mOS2: 3.3 vs 5.5 months, P = .06). In an exploratory analysis of the TL-pre-CAR-T set, the median TAFA-LEN treatment duration before CAR-T was 3.7 months with no patient becoming CD19 negative. The bORR, bCRR, 6- month PFS, and OS rates after CAR T-cell infusion were 45.5%, 36.4%, 20.1%, and 58.2%, respectively. Neither TAFA-LEN nor comparative salvage treatment improved outcomes for patients relapsing after CAR T-cell therapy.

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Conflict of interest statement

Conflict-of-interest disclosure: V.C. has received honoraria from Incyte, AbbVie, AstraZeneca, Bristol Myers Squibb, Ideogen, Janssen, Kyowa Kirin, Kite/Gilead, Lilly, Novartis, Octapharma, Pfizer, Pierre Fabre, Sanofi, and Takeda. P.S. has received honoraria from Chugai, BMS, Novartis, Janssen, Kite/Gilead, AbbVie, and Roche. J.P. has received honoraria from Incyte. L.D.L.R. has received honoraria from Novartis and Kite/Gilead. The remaining authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Study flowchart. DESCAR-T, Dispositif d'Enregistrement et Suivi des patients traités par CAR T cells.
Figure 2.
Figure 2.
Outcomes Based on Timing of Progression After CAR T-Cell Therapy. PFS (A) and OS (B) since treatment for the first progression (PFS2 and OS2) in the TL-post-CAR-T set according to early (≤6 months) vs late (>6 months) TAFA-LEN introduction. CI, confidence interval; NA, not available.
Figure 3.
Figure 3.
Comparison between TAFA-LEN and other treatments as initial therapies for progression after CAR T-cell therapy. PFS (A) and OS (B) since the first treatment for progression after CAR T-cell therapy according to IPW using stabilized weight (SW) method between TAFA-LEN and other treatments.
Figure 4.
Figure 4.
Comparison between TAFA-LEN and LEN as initial therapies for progression after CAR T-cell therapy. PFS (A) and OS (B) since the first treatment for progression after CAR T-cell therapy according to IPW using SW between TAFA-LEN and LEN (single agent).
Figure 5.
Figure 5.
Outcomes after CAR T-cell infusion. PFS (A) and OS (B) after CAR T-cell infusion in the TL-pre-CAR-T set.
See this image and copyright information in PMC

References

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