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. 2025 Feb 18;9(2):e70091.
doi: 10.1002/hem3.70091. eCollection 2025 Feb.

Outcomes of patients with relapsed or refractory primary mediastinal B-cell lymphoma treated with anti-CD19 CAR-T cells: CARTHYM, a study from the French national DESCAR-T registry

Jean Galtier  1 , Charles Mesguich  2 , Pierre Sesques  3 , Vivien Dupont  4 , Emmanuel Bachy  3 , Roberta Di Blasi  5 , Catherine Thieblemont  5 , Thomas Gastinne  6 , Guillaume Cartron  7 , Gabriel Brisou  8 , François-Xavier Gros  1 , Justine Decroocq  9 , Franck Morschhauser  10 , Marie-Thérèse Rubio  11 , Laurianne Drieu La Rochelle  12 , Fabien Le Bras  13 , Sylvain Carras  14 , Adrien Chauchet  15 , Jacques-Olivier Bay  16 , Magalie Joris  17 , Mickael Loschi  18 , Aline Tanguy-Schmidt  19 , Alexandra Marquet  20 , Vincent Camus  21 , Steven Le Gouill  22 , Roch Houot  23 , Krimo Bouabdallah  1
Affiliations

Outcomes of patients with relapsed or refractory primary mediastinal B-cell lymphoma treated with anti-CD19 CAR-T cells: CARTHYM, a study from the French national DESCAR-T registry

Jean Galtier et al. Hemasphere. .

Abstract

Primary mediastinal B-cell lymphoma (PMBL) is often cured with dose-dense anthracycline-based regimens but the prognosis at relapse or progression remains poor. While anti-CD19 CAR-T cell therapy has dramatically improved outcomes in relapsed or refractory large B-cell lymphoma, far less is known about their efficacy in PMBL. Using the systematic record of all patients treated with CAR-T cells prospectively included in the DESCAR-T registry in France, along with centrally reviewed positon-emission tomography (PET) imaging, we describe the outcomes and key determinants of treatment success in PMBL patients treated over a 6-year period. Among 82 patients infused in the registry we observed a best complete response (CR) rate, 2-year progression-free survival (PFS), and 2-year overall survival (OS) of 68.1%, 57.4%, and 73.8%, respectively. Outcomes were even better for the 62 patients infused with axicabtagene ciloleucel, with best CR rate, 2-year PFS, and 2-year OS reaching 74.5%, 70.4%, and 86.9%, respectively. Achieving a Deauville score of 1-4 or a ΔSUVmax reduction of more than 24% at the 1-month evaluation was associated with excellent outcomes, whereas increased total metabolic tumor volume baseline PET increased the risk of treatment failure. Surprisingly, neither the response to bridging therapy nor the type of bridging therapy (chemotherapy versus immune checkpoint inhibitors) were associated with long-term outcomes. In conclusion, this study confirms that anti-CD19 CAR-T cells as a valid standard-of-care for relapsed and refractory PMBL and highlights key determinants of treatment success.

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Conflict of interest statement

Jean Galtier, Roberta Di Blasi, François‐Xavier Gros, Sylvain Carras, Krimo Bouabdallah: Honoraria from Kite/Gilead. Vincent Camus: Honoraria from Incyte, AbbVie, AstraZeneca, Bristol Myers Squibb, Ideogen, Janssen, Kyowa Kirin, Kite/Gilead, Lilly, Novartis, Octapharma, Pfizer, Pierre Fabre, Sanofi, and Takeda, all of which are unrelated to the present study. Pierre Sesques: Honoraria, Advisory/Consultancy from Janssen, Roche, BMS, Chugai; Novartis, Abbvie and Kite/Gilead. Catherine Thieblemont: speaker: AbbVie, Amgen, Bayer, Bristol Myers Squibb/Celgene, Gilead Sciences Inc, Incyte Corporation, Janssen, Kite, Novartis, Roche, Takeda; Travel and accommodation: AbbVie, Amgen, Bayer, Bristol Myers Squibb/Celgene, Gilead Sciences Inc, Janssen, Kite, Novartis, Roche, Takeda; Research grant: Janssen, Roche; Consultancy/Honoraria: AbbVie, Amgen, Bayer, Bristol Myers Squibb/Celgene, Gilead Sciences Inc, Novartis, Roche, Incyte Corporation, Janssen, Kite, Takeda. Emmanuel Bachy: AbbVie, Roche, Takeda: Membership on an entity's Board of Directors or advisory committees, Consultancy, Honoraria ADC Therapeutics: Honoraria Amgen: Research Funding BeiGene: Membership on an entity's Board of Directors or advisory committees, Honoraria Bristol Myers Squibb: Honoraria, Other, Research Funding Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees Janssen: Honoraria, Consultancy Kite, a Gilead Company: Consultancy, Honoraria, Other Novartis: Honoraria, Other Pfizer: Honoraria, Other. Franck Morschhauser: consultancy: Roche/Genentech; consultancy and membership on an entity's Board of Directors or advisory committees: Kite/Gilead Sciences, Bristol Myers Squibb, AbbVie, Epizyme, AstraZeneca, Novartis, Genmab; Honoraria: Roche/Genentech, Chugai, Takeda. Guillaume Cartron: Consultancies. Roche, Celgene‐BMS, Abbvie, Milteny Scientific Advisory Boards. Onwards Therapeutics, MedxCell, EmerCell, MabQi Honoraria. Sanofi, Abbvie, Takeda, Janssen, Roche, Celgene, Novartis, Incyte. Roch Houot: Honoraria from Kite/Gilead, Novartis, Bristol‐Myers Squibb/Celgene, Incyte, Janssen, MSD, Takeda, Amgen, Abbvie, and Roche; and is a member on an entity's Board of Directors or advisory committees of Kite/Gilead, Novartis, Bristol‐Myers Squibb/Celgene, Tessa Therapeutics, Abbvie and Roche. The remaining authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the study population.
Figure 2
Figure 2
(A) Progression‐free survival and (B) overall survival of all CAR‐T infused patients.
Figure 3
Figure 3
(A) Progression‐free survival, (B) overall survival of axi‐cel infused patients, (C) progression‐free survival according to Deauville score 1 month after axi‐cel infusion, and (D) progression‐free survival according to ΔSUVmax between baseline positon‐emission tomography (PET) and M1 PET.
Figure 4
Figure 4
(A) Progression‐free survival and (B) overall survival of PMBL and other DLBCL treated with axi‐cel in the French DESCAR‐T registry. DLBCL, diffuse large B‐cell lymphoma; PMBL, Primary mediastinal B‐cell lymphoma.
Figure 5
Figure 5
Progression‐free survival of axi‐cel infused patients according to baseline TMTV. TMTV, total metabolic tumor volume.
See this image and copyright information in PMC

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