e-Article
Polatuzumab-based regimen or CAR T cell for patients with refractory/relapsed DLBCL—a matched cohort analysis
Document Type
Original Paper
Author
Avivi, Irit; Perry, Chava; Segman, Yafit; Amit, Odelia; Bar-On, Yaeli; Katz, Ofrat Beyer; Gold, Ronit; Ribakovsky, Elena; Avigdor, Abraham; Vainstein, Vladimir; Goldschmidt, Neta; Ringelstein-Harlev, Shimrit; Horowitz, Netanel A.; Gutwein, Odit; Gurion, Ronit; Itchaki, Gilad; Abadi, Uri; Nemets, Anatoly; Sofer, Orit; Vezker, Miri; Tadmor, Tamar; Dally, Najib; Filanovsky, Kalman; Leiba, Merav; Sarid, Nadav; Benyamini, Noam; Luttwak, Efrat; Herishanu, Yair; Ram, Ron
Source
Annals of Hematology. 101(4):755-762
Subject
Language
English
ISSN
0939-5555
1432-0584
1432-0584
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.