Chimeric antigen receptor (CAR) T-cell therapy does not appear to be more effective than chemotherapy plus autologous stem cell transplantation in the second-line treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL), according to a new study published Cancer Research and Treatment. It also does not seem to be superior to other recently developed agents used in patients who are not eligible for autologous stem cell transplantation.
Read more about the treatment of DLBCL
The authors of the study conducted a meta-analysis to evaluate the efficacy of salvage treatments for relapsed or refractory DLBCL.
They divided clinical trials on DLBCL treatments into 2 groups based on whether patients were eligible for autologous stem cell transplantation. They then conducted a meta-analysis for each group.
There were 26 cohorts including 2924 patients who were eligible for autologous stem cell transplantation from 17 studies and 59 cohorts including 3617 patients who were not eligible for autologous stem cell transplantation from 53 studies.
The results showed that the pooled 1-year progression-free survival rates of patients who were eligible for autologous stem cell transplantation were 0.4 when they were treated with CAR T-cell therapy and 0.34 when they were treated with chemotherapy and subsequent autologous stem cell transplantation.
“The two treatments were not significantly different in meta‐regression analysis,” the researchers reported.
In patients who were not eligible for autologous stem cell transplantation, the pooled 1-year progression-free survival rate was also 0.4. The highest progression-free survival rate was 0.47, which was obtained with tafasitamab treatment.
“CAR T-cell therapy showed significantly better outcomes than chemotherapy and therapies based on ibrutinib, lenalidomide, and selinexor,” the researchers said. However, the efficacy of the treatment was not different from that of loncastuximab, polatuzumab plus bendamustine and rituximab, and tafasitamab when the data were adjusted based on the median number of previous lines of treatment.
“Given the limited number of relevant trials available for each treatment category group and their heterogeneity, further well-conducted large-scale studies are required to corroborate our findings,” they concluded.
Reference
Kim J, Cho J, Yoon SE, Kim WS, Kim SJ. Efficacy of salvage treatments in relapsed or refractory diffuse large B-cell lymphoma including chimeric antigen receptor T-cell therapy: a systematic review and meta‐analysis. Published online March 13, 2023. doi:10.4143/crt.2022.1658
