POLATUZUMAB VEDODTIN VS. CAR-T CELL FOR PATIENTS WITH RELAPSED/ REFRACTORY DIFFUSE LARGE B CELL LYMPHOMA - A PROPENSITY SCORE MATCHED ANALYSIS
Author(s): ,
Irit Avivi
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Chava Perry
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Yafit Segman
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Odelia Amit
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Yaeli Bar-On
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Ofrat Biar
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Efrat Lutwak
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Ronit Gold
Affiliations:
Tel Aviv Sourasky Medical Center,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
,
Elena Ribakovsky
Affiliations:
Hematology,sheba,TEL AVIV,Israel
,
Avraham Avigdor
Affiliations:
Hematology,Sheba,Tel-Aviv,Israel
,
Vladimir Vainstein
Affiliations:
Hematology,Hadassah,Jerusalem,Israel
,
Neta Goldschmidt
Affiliations:
Hematology,Hadassah,Jerusalem,Israel
,
Shimrit Harlev
Affiliations:
Hematology,Rambam,Haifa,Israel
,
Netanel Horwitz
Affiliations:
Hematology,Rambam,Haifa,Israel
,
Odit Gutwein
Affiliations:
Hematology,Shamir,Beer Yaakov,Israel
,
Ronit Gurion
Affiliations:
Hematology,rabin medical center,petah tikva,Israel
,
Gilad Itchaki
Affiliations:
Hematology,rabin medical center,petah tikva,Israel
,
Uri Abadi
Affiliations:
Hematology,meir medical center,kfar saba,Israel
,
Anatoly Nemets
Affiliations:
Hematology,barzilai,ashkelon,Israel
,
Miri Zektser
Affiliations:
Hematology,soroka medical center,beer sheva,Israel
,
Tamar Tadmor
Affiliations:
Hematology,Bnai Zion Medical Center,Haifa,Israel
,
Nagib Dally
Affiliations:
Hematology,ziv medical center,tzfat,Israel
,
Kalman Filanovsky
Affiliations:
Hematology,Kaplan Medical Center,Yavne,Israel
,
Merav Leiba
Affiliations:
Hematology,Assuta Center,ashdod,Israel
,
Noam benyamini
Affiliations:
Hematology,Tel Aviv Sourasky Medical Center,Tel-Aviv,Israel
,
Yair Herishanu
Affiliations:
Hematology,Tel Aviv Sourasky Medical Center,Tel-Aviv,Israel
Ron Ram
Affiliations:
Hematology,Tel Aviv Sourasky Medical Center,Tel-Aviv,Israel
EHA Library. Avivi I. 06/09/21; 324663; S255
Irit Avivi
Irit Avivi
Contributions
Abstract
Presentation during EHA2021: All Oral presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: S255

Type: Oral Presentation

Session title: Cellular immunotherapy and gene therapy - Clinical

Background:
Introduction -Pola -BR (Polatuzumab -bendamustin- rituximab) and chimeric antigen receptor (CAR)-T cells provide superior outcome compared to conventional chemotherapy in patients with relapsed/refractory diffuse large B cell lymphoma (R/R DLBCL). However, how to sequence these strategies remains controversial.

Methods:
The study included R/R DLBCL patients, treated between 01/2019-08/2020 with commercial CAR-T or Pola/Pola BR after failing ≥2 lines of treatment. Propensity score analysis, matching patients based on age, lymphoma category (de-novo/ transformed), cell of origin, number of prior therapy lines, ECOG performance status and LDH level, was performed. Response rate, progression free survival (PFS) and overall survival (OS) were analyzed.


Results:
98 patients, treated with CAR-T (n=49; 35 with Tisagenlecleucel, and 14 with Axicabtagene ciloleucel) or Pola-based regimen (n=49) were included (patient characteristics are presented in Table 1). Median time from progressive disease to CAR-T infusion was 52 days and mostly immediate for Pola/Pola-BR. Non-relapse mortality was 0 in the CAR-T cohort vs 6% (3/49) in the Pola arm. The overall and complete response rates were 73% and 53% for the CAR-T cohort vs 63% and 20% in the Pola arm. Within a median follow-up period of 9.6 (range, 1-19.1) and 7.7 (range, 0.7-26) months for CAR-T and Pola patients, respectively, median PFS were 8.9 month (95% CI n/a) vs. 5.6 months (95% CI 3.7-7.6) ( p=0.08) and median OS was not reached vs. 10.8 (2.2-19.4) months, (p=0.12), respectively( Figures 1A, 1B).



CAR-T- Chimeric Antigen Receptor- T cell ;DLBCL- diffuse large cell B cell lymphoma; ECOG PS- Eastern Cooperative Oncology Group performance status; LDH- ; lactic dehydrogenase; No- number Pola-polatuzumab vedotin Axicabtagene ciloleucel, N=14; Tisagenlecleucel, N=35*

Conclusion:
Conclusions - In the lack of prospective randomized trials evaluating CAR-T s vs chemo-immunotherapy, a propensity score, comparing CAR-T with Pola-based regimen was performed, demonstrating a tendency for prolonged PFS and OS in R/R DLBCL patients treated with CAR-T.

Keyword(s):

Presentation during EHA2021: All Oral presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: S255

Type: Oral Presentation

Session title: Cellular immunotherapy and gene therapy - Clinical

Background:
Introduction -Pola -BR (Polatuzumab -bendamustin- rituximab) and chimeric antigen receptor (CAR)-T cells provide superior outcome compared to conventional chemotherapy in patients with relapsed/refractory diffuse large B cell lymphoma (R/R DLBCL). However, how to sequence these strategies remains controversial.

Methods:
The study included R/R DLBCL patients, treated between 01/2019-08/2020 with commercial CAR-T or Pola/Pola BR after failing ≥2 lines of treatment. Propensity score analysis, matching patients based on age, lymphoma category (de-novo/ transformed), cell of origin, number of prior therapy lines, ECOG performance status and LDH level, was performed. Response rate, progression free survival (PFS) and overall survival (OS) were analyzed.


Results:
98 patients, treated with CAR-T (n=49; 35 with Tisagenlecleucel, and 14 with Axicabtagene ciloleucel) or Pola-based regimen (n=49) were included (patient characteristics are presented in Table 1). Median time from progressive disease to CAR-T infusion was 52 days and mostly immediate for Pola/Pola-BR. Non-relapse mortality was 0 in the CAR-T cohort vs 6% (3/49) in the Pola arm. The overall and complete response rates were 73% and 53% for the CAR-T cohort vs 63% and 20% in the Pola arm. Within a median follow-up period of 9.6 (range, 1-19.1) and 7.7 (range, 0.7-26) months for CAR-T and Pola patients, respectively, median PFS were 8.9 month (95% CI n/a) vs. 5.6 months (95% CI 3.7-7.6) ( p=0.08) and median OS was not reached vs. 10.8 (2.2-19.4) months, (p=0.12), respectively( Figures 1A, 1B).



CAR-T- Chimeric Antigen Receptor- T cell ;DLBCL- diffuse large cell B cell lymphoma; ECOG PS- Eastern Cooperative Oncology Group performance status; LDH- ; lactic dehydrogenase; No- number Pola-polatuzumab vedotin Axicabtagene ciloleucel, N=14; Tisagenlecleucel, N=35*

Conclusion:
Conclusions - In the lack of prospective randomized trials evaluating CAR-T s vs chemo-immunotherapy, a propensity score, comparing CAR-T with Pola-based regimen was performed, demonstrating a tendency for prolonged PFS and OS in R/R DLBCL patients treated with CAR-T.

Keyword(s):

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