Relapsed/refractory diffuse large B-cell lymphoma patients. A multicenter retrospective analysis of eligibility criteria for car-T cell therapy
Alice Di Rocco, Alice Di Rocco, Antonio Cuneo, Arianna Di Rocco, Arianna Di Rocco, Francesco Merli, Giulia De Luca, Luigi Petrucci, Michela Ansuinelli, Domenico Penna, Francesco Rotondo, Gian Matteo Rigolin, Mariateresa Giaimo, Francesca Re, Alessio Farcomeni, Maurizio Martelli, Robin Foà
Abstract
Anti-CD19 chimeric antigen receptor (CAR) T cells represent the first approved third-line therapy associated with long-term remissions in patients with refractory/relapsed (R/R) diffuse large B-cell lymphoma (DLBCL). Eligibility criteria to identify patients who can successfully receive CAR-T are still debated. For this reason, the aim of this study was to identify factors influencing eligibility and define a realistic patient estimate. Of 1100 DLBCL patients, 137 were included. Based on the Juliet trial inclusion criteria, only 64 patients (46.7%) would be eligible. Median overall survival (OS) was 8.04 months in eligible vs 3.23 in non-eligible patients (p < 0.001). Multivariate analysis identified stage III-IV (p = 0.017) and ECOG ≥2 (p < 0.001) as significant independent prognostic factors for OS. Moreover, only 64/1100 (5.8%) DLBCL patients would be truly eligible for CAR-T. Our real-life data confirm that with a longer waiting time patients with advanced stage and poor ECOG are less likely to be eligible for CAR-T cell infusion.