Impact of Bridging Response on Outcomes After CD19 CAR T-Cell Therapy in Large B-Cell Lymphoma - PubMed
2 hours ago
- #CAR T-cell therapy
- #Lymphoma outcomes
- #Bridging therapy
- Bridging therapy (BT) is commonly used during CD19 CAR T-cell manufacturing for relapsed or refractory large B-cell lymphoma (LBCL), but the impact of BT response on outcomes has been variably defined.
- This retrospective multicenter study of 377 adults with LBCL found that 66% received BT, with an overall response rate of 49% prior to CAR T infusion, including 12% achieving complete response.
- Patients achieving complete or partial response to BT had significantly longer progression-free survival (PFS) and overall survival (OS) compared to those with stable or progressive disease.
- Multivariable analysis showed that BT response was an independent predictor of PFS and OS, while the BT modality itself was not independently associated with survival outcomes.
- Favorable BT responses were linked to lower pre-infusion tumor burden and reduced inflammatory markers, but did not significantly affect rates of cytokine release syndrome or neurotoxicity.
- Severe hematologic toxicity was more frequent with intensive chemotherapy-based BT regimens, but this did not independently impact long-term outcomes.
- The study concludes that response to BT, rather than the specific BT modality, strongly correlates with improved survival after CD19 CAR T-cell therapy, highlighting the importance of pre-infusion disease control.