A national service for delivering CD19 CAR-Tin large B-cell lymphoma – The UK real-world experience

Andrea Kuhnl*, Claire Roddie, Amy A. Kirkwood, Eleni Tholouli, Tobias Menne, Amit Patel, Caroline Besley, Sridhar Chaganti, Robin Sanderson, Maeve O'Reilly, Jane Norman, Wendy Osborne, Adrian Bloor, Sanne Lugthart, Ram Malladi, Piers E.M. Patten, Lorna Neill, Nuria Martinez-Cibrian, Hannah Kennedy, Elizabeth H. PhillipsCeri Jones, Kirsty Sharplin, Dima El-Sharkawi, Anne Louise Latif, Amrith Mathew, Benjamin Uttenthal, Orla Stewart, Maria A.V. Marzolini, William Townsend, Kate Cwynarski, Kirit Ardeshna, Arzhang Ardavan, Kate Robinson, Antonio Pagliuca, Graham P. Collins, Roderick Johnson, Andrew McMillan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)

Abstract

CD19 CAR-T have emerged as a new standard treatment for relapsed/refractory (r/r) large B-cell lymphoma (LBCL). CAR-T real-world (RW) outcomes published to date suggest significant variability across countries. We provide results of a large national cohort of patients intended to be treated with CAR-T in the UK. Consecutive patients with r/r LBCL approved for CAR-T by the National CAR-T Clinical Panel between December 2018 and November 2020 across all UK CAR-T centres were included. 404/432 patients were approved [292 axicabtagene ciloleucel (axi-cel), 112 tisagenlecleucel (tisa-cel)], 300 (74%) received the cells. 110/300 (38.3%) patients achieved complete remission (CR) at 6 months (m). The overall response rate was 77% (52% CR) for axi-cel, 57% (44% CR) for tisa-cel. The 12-month progression-free survival was 41.8% (axi-cel) and 27.4% (tisa-cel). Median overall survival for the intention-to-treat population was 10.5 m, 16.2 m for infused patients. The incidence of grade ≥3 cytokine release syndrome and neurotoxicity were 7.6%/19.6% for axi-cel and 7.9%/3.9% for tisa-cel. This prospective RW population of CAR-T eligible patients offers important insights into the clinical benefit of CD19 CAR-T in LBCL in daily practice. Our results confirm long-term efficacy in patients receiving treatment similar to the pivotal trials, but highlight the significance of early CAR-T failure.

Original languageEnglish
Pages (from-to)492-502
Number of pages11
JournalBritish Journal of Haematology
Volume198
Issue number3
DOIs
Publication statusPublished - Aug 2022

Keywords

  • cellular therapies
  • lymphoid malignancies
  • lymphomas

Fingerprint

Dive into the research topics of 'A national service for delivering CD19 CAR-Tin large B-cell lymphoma – The UK real-world experience'. Together they form a unique fingerprint.

Cite this