Outcomes of Bridging Therapy in Patients With Relapsed/Refractory Large B Cell Lymphoma Receiving Third-Line CAR T - PubMed
6 hours ago
- #CAR T therapy
- #bridging therapy
- #large B-cell lymphoma
- Bridging therapy (BT) is commonly used in relapsed/refractory large B-cell lymphoma (LBCL) patients undergoing CAR T therapy, but the optimal approach is uncertain.
- Study evaluated BT strategies (chemotherapy, polatuzumab-based, radiotherapy, corticosteroids, or none) in 219 patients receiving third-line or later CAR T therapy.
- Polatuzumab-based BT and radiotherapy showed higher overall response rates (ORR) (50% and 40% respectively) compared to chemotherapy (16%).
- Radiotherapy covering all active disease had a higher ORR (51%) versus non-comprehensive radiotherapy (12%).
- Two-year progression-free survival (PFS) was highest with radiotherapy (47%) and polatuzumab (37%) compared to chemotherapy (21%).
- Adjusted analyses showed improved PFS with radiotherapy (aHR 0.29) and polatuzumab (aHR 0.41). Overall survival (OS) also improved with radiotherapy (HR 0.40).
- Chemotherapy BT was associated with the highest 2-year lymphoma-related mortality (74%).
- Polatuzumab-based and radiotherapy BT, as well as no BT, showed better outcomes than chemotherapy, though patient selection may influence results.
- Prospective studies are needed to define optimal, individualized BT strategies.