Outcomes of tafasitamab and lenalidomide in large B‐cell lymphoma based on prior CD19‐directed CAR T exposure
Year: 2025
Type: article
Study design: Observational Study
Abstract: The treatment landscape of relapsed and refractory (R/R) diffuse large B-cell lymphoma (DLBCL) has significantly improved with the development of CD19-directed chimeric antigen receptor T-cell therapy (CAR T). 1,2 Even so, approximately 50%-60% of patients treated with CAR T will ultimately experience disease progression.3 Tafasitamab (tafa) and loncastuximab tesirine (lonca) both target CD19 and are approved for the treatment of R/R DLBCL.Following the approval of CAR T in the second-line setting, 4,5 these agents may be used to treat DLBCL after CAR T failure.Notably, the L-MIND study of tafa with lenalidomide (tafa/len) excluded patients with prior CAR T, while the LOTIS-2 study for lonca enrolled only 13 post-CAR T patients.6,7 Prior reports, including our own, have shown poor outcomes with CD19-directed therapies following CAR T, though it remains unclear whether this reflects the effects of prior CAR T itself or underlying high-risk disease features.8,9 We aimed to evaluate the impact of prior CD19-directed therapy on subsequent CD19-based treatment, focusing on the impact of prior CD19 CAR T on tafa/len efficacy.We compared CAR T-exposed versus CAR T-naïve patients receiving tafa/len, and used propensity score matching to address baseline imbalances between CAR-exposed and CAR-naïve cohorts.We also explored CD19 expression patterns and outcomes with other CD19-directed sequences, including lonca and CAR T.This multicenter, retrospective cohort study included adults (≥18 years) with R/R DLBCL treated with tafa between August 2020 and August 2022 across 11 institutions.Eligible histologies included DLBCLnot otherwise specified (NOS), high-grade B-cell lymphoma (HGBCL), transformed indolent lymphomas, T-cell/histiocyte-rich large B-cell lymphoma, and primary mediastinal B-cell lymphoma.Responses to therapy were evaluated by each site using routine imaging and assessments.CD19 expression was locally assessed by immunohistochemistry or flow cytometry and defined as positive by local center criteria.
Source: HemaSphere
DOI: 10.1002/hem3.70253
Authors: Mwanasha H. Merrill, Robert A. Redd, Nicholas Lambert, Paolo F. Caimi, Priyanka Pullarkat, Richard C. Godby, David A. Bond, Graham T. Wehmeyer, Jason Romancik, Behzad Amoozgar, Lori Leslie, Loretta J. Nastoupil, Jennifer L. Crombie, Jeremy S. Abramson, Arushi Khurana, Grzegorz S. Nowakowski, Kami Maddocks, Sarah C. Rutherford, Brad Kahl, Michelle Okwali, Michael J. Buege, Connie L. Batlevi, Philippe Armand, Gilles Salles, David A. Qualls
Institutions: University of California, San Francisco, Dana-Farber Cancer Institute, Baylor College of Medicine, Cleveland Clinic, Massachusetts General Hospital, Mayo Clinic, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, NewYork–Presbyterian Hospital, Weill Cornell Medicine, Emory University, Winship Cancer Institute, Washington University in St. Louis, Hackensack Meridian Health, The University of Texas MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, University of Illinois Chicago, Genentech
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,480
OpenAlex ID: W4416324762