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Efficacy and Safety of Axicabtagene Ciloleucel (Axi-cel) for the Treatment of Relapse/Refractory Non-Hodgkin Lymphoma: Real-World Data in Chinese Population

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单位: [1]Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Shanghai, Peoples R China [2]Chinese Acad Med Sci & Peking Union Med Coll, State Key Lab Expt Hematol, Natl Clin Res Ctr Blood Dis, Haihe Lab Cell Ecosyst,Inst Hematol, Tianjin, Peoples R China [3]Chinese Acad Med Sci & Peking Union Med Coll, Blood Dis Hosp, Tianjin, Peoples R China [4]Southern Med Univ, Zhujiang Hosp, Dept Hematol, Guangzhou, Peoples R China [5]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Hematol, Wuhan, Peoples R China [6]Fudan Univ, Dept Med Oncol, Shanghai Canc Ctr, Shanghai, Peoples R China [7]Zhejiang Univ, Coll Med, Affiliated Hosp 2, Dept Hematol, Hangzhou, Peoples R China [8]Ningbo Univ, Affiliated Peoples Hosp, Dept Hematol, Ningbo, Peoples R China [9]Shandong Univ, Qilu Hosp, Dept Hematol, Cheeloo Coll Med, Jinan, Peoples R China [10]Zhengzhou Univ, Henan Canc Hosp, Canc Hosp, Dept Hematol, Zhengzhou, Peoples R China [11]Peking Univ Third Hosp, Dept Hematol, Beijing, Peoples R China [12]Peking Univ Third Hosp, Lymphoma Res Ctr, Beijing, Peoples R China [13]Hongkong Univ, Shenzhen Hosp, Dept Hematol, Shenzhen, Peoples R China [14]Tianjin Med Univ Canc Inst & Hosp, Tianjin, Peoples R China [15]Nanchang Univ, Affiliated Hosp 1, Dept Hematol, Nanchang, Jiangxi, Peoples R China [16]Xuzhou Med Univ, Dept Hematol, Affiliated Hosp, Xuzhou, Jiangsu, Peoples R China [17]Sichuan Univ, West China Hosp, Dept Hematol, Chengdu, Peoples R China [18]Soochow Univ, Affiliated Hosp 1, Suzhou, Peoples R China [19]Huazhong Univ Sci & Technol, Tongji Med Coll, Union Hosp, Inst Hematol, Wuhan, Peoples R China [20]Shanghai Jiao Tong Univ, Shanghai Inst Hematol, State Key Lab Med Genom,Sch Med, Natl Res Ctr Translat Med Shanghai,Rui Jin Hosp, Shanghai, Peoples R China
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Background: Autologous CD-19 directed chimeric antigen receptor (CAR) T-cell therapy has become the standard of care of patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) who have received two or more prior lines of therapy. In June 2021, Axi-cel was approved by the China National Medical Products Administration (NMPA) for the treatment of these patients as the first commercial CAR-T product in China. To better understand the efficacy and safety of commercial Axi-cel in Chinese R/R NHL patients in a real-world setting, we conducted this multi-center, non-interventional study (ChiCTR2100047990). The accrual goal is 200 patients, and the primary endpoint is mOS. Here we made the pre-specific interim analysis and the reported the clinical outcomes. Methods: We included R/R NHL patients treated with commercial Axi-cel at 17 authorized treatment centers from November 2021 to February 2023. All the patients signed written informed consent. We reported best objective response rate (bORR), best complete response (bCR) rate and adverse events of special interest (AESI), including cytokine release syndrome (CRS) and neurological events (NE). Results: To the cut-off date of June 8, 2023, a total of 101 R/R NHL patients had undergone efficacy evaluation at month 3. The median age of patients was 56.5 (22, 80) years, with 23 patients (22.8%) aged 65 years or older. Fifty-nine patients were male. The baseline characteristics of these patients included 81 (80.2%) with diffuse large B-cell lymphoma, 4 (4.0%) with primary mediastinal B-cell lymphoma, and 7 (6.9%) with high-grade B-cell lymphoma. More than 50% of patients had an International Prognostic Index (IPI) score ≥3. The median number of prior treatment was 2. Thirty-eight patients (37.6%) had received 3 or more previous therapies and 10 patients (9.9%) had undergone autologous stem cell transplantation (ASCT). The primary refractory subgroup reached 46 (45.5%), and 41(40.6%) patients were refractory to second-line or subsequent therapy. Notably, compared to the baseline characteristics of Axi-cel real-world studies for R/R LBCL in other countries, a greater proportion of Chinese patients had an ECOG PS score ≥2 (32.7%), HBsAg (+) with normal HBV-DNA (23.1%), HBsAg (-) accompany with HBcAb (+) (37.1%). Bridging therapy was given in 73 patients (72.3%), while combination anti-lymphoma therapy was used after Axi-cel infusion and before disease progression in 52 patients (51.5%).

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大类 | 1 区 医学
小类 | 1 区 血液学
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大类 | 1 区 医学
小类 | 1 区 血液学
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Q1 HEMATOLOGY
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Q1 HEMATOLOGY

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第一作者单位: [1]Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Shanghai, Peoples R China
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