AHSCT Produces Better Outcomes Than CAR-T Therapy in Patients with LBCL Achieving a CR

By Leah Sherwood - Last Updated: December 14, 2023

In patients with relapsed large B-cell lymphoma (LBCL) who achieve a complete remission (CR), treatment with autologous hematopoietic stem cell transplantation (AHSCT) is associated with a lower relapse rate and an improved progression-free survival (PFS) compared with chimeric antigen receptor (CAR) T-cell therapy, including in patients with early treatment failure (within 12 months), according to a study led by Mazyar Shadman, MD, MPH, of the Fred Hutchinson Cancer Center in Seattle.

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The results were presented as an abstract at the 65th American Society of Hematology Annual Meeting & Exposition in San Diego, California.

The study, based on data from the Center for International Blood & Marrow Transplant Research, compared the outcomes of 360 patients with LBCL who received CAR-T (between 2018 and 2021) versus AHSCT (between 2015 and 2021) while in a CR by positron emission tomography or computed tomography scan. The median follow-up was 24.7 months (range, 3.3-49.4) for the CAR-T cohort and 49.7 months (range, 3.0-95.4) for the AHSCT cohort.

In univariate analysis, treatment with CAR-T was associated with a higher rate of relapse at two years (48% vs 27.8%; P<.001), a lower rate of two-year PFS (47.8% vs 66.2%; P<.001), and lower two-year overall survival (65.6% vs 78.9%; P=.037). Similarly, focusing on patients with early (12 months) treatment failure, treatment with CAR-T was associated with a higher two-year relapse rate (45.9% vs 22.8%; P<.001) and an inferior two-year PFS (48.3% vs 70.9%; P<.001) compared to AHSCT.

“The data support utilization of [autologous transplant] in patients with relapsed LBCL achieving a CR,” the authors concluded.

Reference

Shadman S, Ahn KW, Kaur M, et al. Autologous transplant (auto-HCT) is associated with improved clinical outcomes compared to CAR-T therapy in patients with large B-cell lymphoma (LBCL) achieving a complete remission. Abstract #781. Presented at the 65th ASH Annual Meeting & Exposition; December 9-12, 2023; San Diego, California.

Post Tags:ASHLymphoma2023
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