Abstract
In this retrospective study, chimeric antigen receptor T cells remained effective in patients with relapsed/refractory large B-cell lymphoma after prior exposure to bispecific antibodies (BsAbs) targeting different antigens. These results are relevant to clinical practice, particularly given the increasing use of BsAbs in earlier treatment lines.
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.© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
2024
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Comments
How many patients can move from BsAb to CAR-T therapy or CAR-T to BsAb therapy?
Crochet et al 1 showed that the efficacy of CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy is not impaired by pre-treatment with bispecific antibody (BsAb) treatment. The authors compared the outcomes of CAR-T therapy between BsAb-exposed and BsAb-naïve patients using propensity score matching analysis of real-world data. We are encouraged by the finding that the choice of either CAR-T therapy or BsAb does not affect the response to CAR-T therapy. However, there were concerns that patients who could not receive CAR-T therapy were excluded from this study. Patients who were ineligible for CAR-T therapy due to poor performance status, aggressive disease, etc., and those who could not collect enough lymphocytes for CAR-T therapy were excluded from the analysis. Because of the poor outcome of patients who failed CAR-T or BsAb therapy, only a quarter of patients received reverse treatment 2–4. Therefore, it would be useful for readers to provide us with the percentage of patients who could move from BsAb to CAR-T therapy or CAR-T to BsAb therapy.
NOTES
The author declares no potential conflicts of interest.
References
1. Crochet G, Iacoboni G, Couturier A, et al. Efficacy of CAR T-cell therapy is not impaired by previous bispecific antibody treatment in large B-cell lymphoma. Blood. 2024;144(3):.
2. Di Blasi R, Le Gouill S, Bachy E, et al. Outcomes of patients with aggressive B-cell lymphoma after failure of anti-CD19 CAR T-cell therapy: a DESCAR-T analysis. Blood. 2022;140(24):2584–2593.
3. Thieblemont C, Phillips T, Ghesquieres H, et al. Epcoritamab, a Novel, Subcutaneous CD3xCD20 Bispecific T-Cell-Engaging Antibody, in Relapsed or Refractory Large B-Cell Lymphoma: Dose Expansion in a Phase I/II Trial. Journal of Clinical Oncology. 2023;41(12):.
4. Neelapu SS, Jacobson CA, Ghobadi A, et al. Five-year follow-up of ZUMA-1 supports the curative potential of axicabtagene ciloleucel in refractory large B-cell lymphoma. Blood. 2023;141(19):2307–2315.