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Article Dans Une Revue Blood Année : 2024

Axicabtagene ciloleucel versus standard of care in second-line large B-cell lymphoma: outcomes by metabolic tumor volume.

F. L. Locke
  • Fonction : Auteur
O. O. Oluwole
  • Fonction : Auteur
J. Kuruvilla
  • Fonction : Auteur
G. A. Salles
  • Fonction : Auteur
S. P. Rowe
  • Fonction : Auteur
S. Vardhanabhuti
  • Fonction : Auteur
J. Winters
  • Fonction : Auteur
S. Filosto
  • Fonction : Auteur
C. To
  • Fonction : Auteur
P. Cheng
  • Fonction : Auteur
M. Schupp
  • Fonction : Auteur
R. Korn
  • Fonction : Auteur
M. J. Kersten
  • Fonction : Auteur

Résumé

Metabolic tumor volume (MTV) assessed using 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography, a measure of tumor burden, is a promising prognostic indicator in large B-cell lymphoma (LBCL). This exploratory analysis evaluated relationships between baseline MTV (categorized as low [≤median] vs high [>median]) and clinical outcomes in the phase 3 ZUMA-7 study (NCT03391466). Patients with LBCL relapsed within 12 months of or refractory to first-line chemoimmunotherapy were randomized 1:1 to axicabtagene ciloleucel (axi-cel; autologous anti-CD19 chimeric antigen receptor [CAR] T-cell therapy) or standard care (2-3 cycles of chemoimmunotherapy followed by high-dose chemotherapy with autologous stem-cell transplantation in patients who had a response). All P values are descriptive. Within high and low MTV subgroups, event-free survival (EFS) and progression-free survival (PFS) were superior with axi-cel vs standard care (all HR ≤0.523; P<.01). EFS in patients with high MTV (vs low MTV) was numerically shorter with axi-cel (HR, 1.448; P=.06) and was significantly shorter with standard care (HR, 1.486; P=.02). PFS was shorter in patients with high MTV vs low MTV in both the axi-cel (HR,1.660; P=.02) and standard-care (HR, 1.635; P=.02) arms, and median MTV was lower in patients in ongoing response at data cutoff vs others (both P≤.01). Median MTV was higher in axi-cel-treated patients who experienced grade ≥3 neurologic events or cytokine release syndrome (CRS) than in patients with grade 1/2 or no neurologic events or CRS, respectively (both P≤.03). Baseline MTV ≤median was associated with better clinical outcomes in patients receiving axi-cel or standard care for second-line LBCL.
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hal-04603620 , version 1 (06-06-2024)

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F. L. Locke, O. O. Oluwole, J. Kuruvilla, Catherine Thieblemont, Franck Morschhauser, et al.. Axicabtagene ciloleucel versus standard of care in second-line large B-cell lymphoma: outcomes by metabolic tumor volume.. Blood, 2024, Blood, ⟨10.1182/blood.2023021620⟩. ⟨hal-04603620⟩

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