PMID- 32589728
OWN - NLM
STAT- MEDLINE
DCOM- 20210512
LR  - 20220328
IS  - 2473-9537 (Electronic)
IS  - 2473-9529 (Print)
IS  - 2473-9529 (Linking)
VI  - 4
IP  - 13
DP  - 2020 Jul 14
TI  - Bridging therapy prior to axicabtagene ciloleucel for relapsed/refractory large 
      B-cell lymphoma.
PG  - 2871-2883
LID - 10.1182/bloodadvances.2020001837 [doi]
AB  - The impact of bridging therapy (BT) administered between leukapheresis and 
      chimeric antigen receptor (CAR) T-cell therapy for large B-cell lymphoma (LBCL) 
      is unclear. We evaluated the influence of BT (systemic therapy [ST], radiation 
      therapy [RT], or combined-modality therapy [CMT]) on outcomes of 148 LBCL 
      patients who underwent leukapheresis for planned axicabtagene ciloleucel 
      (axi-cel) infusion. The 55% (n = 81) of patients who received BT were more likely 
      to have international prognostic index (IPI) score >/=3 (P </= .01), bulky disease (P 
      = .01), and elevated lactate dehydrogenase (LDH; P </= .01). The 1-year 
      progression-free (PFS) and overall survival (OS) rates were 40% and 65% in non-BT 
      patients vs 21% and 48% in BT patients (P = .01 and .05, respectively). 
      Twenty-four patients (16%) did not receive axi-cel, most commonly because of 
      lymphoma progression (88%), despite 80% (n = 19) receiving BT. Among 124 patients 
      who received axi-cel, 50% (n = 62) received BT with ST (n = 45), RT (n = 11), or 
      CMT (n = 6); 1-year PFS and OS rates were not significantly different between BT 
      and non-BT cohorts (P = .06 and .21, respectively). There was no difference in 
      proportion of patients with IPI >/=3, limited-stage disease, or elevated LDH 
      between ST, RT, and CMT groups. Compared with non-BT patients, 1-year PFS was 
      inferior for ST-bridged patients (P = .01). RT-bridged patients had improved PFS 
      compared with ST-bridged patients (P = .05). Despite the poor prognosis 
      associated with requiring BT, RT can be an effective bridging strategy. Future 
      studies are necessary to identify strategies that may improve access to CAR 
      T-cell therapy and outcomes.
CI  - (c) 2020 by The American Society of Hematology.
FAU - Pinnix, Chelsea C
AU  - Pinnix CC
AD  - Department of Radiation Oncology and.
FAU - Gunther, Jillian R
AU  - Gunther JR
AD  - Department of Radiation Oncology and.
FAU - Dabaja, Bouthaina S
AU  - Dabaja BS
AD  - Department of Radiation Oncology and.
FAU - Strati, Paolo
AU  - Strati P
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Fang, Penny
AU  - Fang P
AD  - Department of Radiation Oncology and.
FAU - Hawkins, Misha C
AU  - Hawkins MC
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Adkins, Sherry
AU  - Adkins S
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Westin, Jason
AU  - Westin J
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Ahmed, Sairah
AU  - Ahmed S
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Fayad, Luis
AU  - Fayad L
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Lee, Hun Ju
AU  - Lee HJ
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Nair, Ranjit
AU  - Nair R
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Steiner, Raphael E
AU  - Steiner RE
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Iyer, Swaminathan P
AU  - Iyer SP
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Rodriguez, M Alma
AU  - Rodriguez MA
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Wang, Michael
AU  - Wang M
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Flowers, Christopher
AU  - Flowers C
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Neelapu, Sattva S
AU  - Neelapu SS
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
FAU - Nastoupil, Loretta J
AU  - Nastoupil LJ
AD  - Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, 
      Houston, TX.
LA  - eng
GR  - P30 CA016672/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Blood Adv
JT  - Blood advances
JID - 101698425
RN  - 0 (Antigens, CD19)
RN  - 0 (Biological Products)
RN  - U2I8T43Y7R (axicabtagene ciloleucel)
SB  - IM
CIN - Blood Adv. 2020 Jul 14;4(13):2884-2885. PMID: 32589726
CIN - Strahlenther Onkol. 2021 Dec;197(12):1154-1156. PMID: 34704117
MH  - Antigens, CD19/therapeutic use
MH  - Biological Products
MH  - Humans
MH  - *Immunotherapy, Adoptive
MH  - *Lymphoma, Large B-Cell, Diffuse/drug therapy
MH  - Survival Rate
PMC - PMC7362355
COIS- Conflict-of-interest disclosure: S.S.N. has received research support from 
      Kite/Gilead, Cellectis, Poseida, Merck, Acerta, Karus, Bristol-Myers Squibb, Unum 
      Therapeutics, Allogene, and Precision Biosciences; has served as a consultant and 
      advisory board member for Kite/Gilead, Bristol-Myers Squibb, Celgene, Novartis, 
      Unum Therapeutics, Pfizer, Merck, Precision Biosciences, Cell Medica, Incyte, 
      Allogene, Calibr, and Legend Biotech; and has patents related to cell therapy. 
      M.W. has received research support from Kite/Gilead and has served as a 
      consultant for Kite/Gilead. The remaining authors declare no competing financial 
      interests.
EDAT- 2020/06/27 06:00
MHDA- 2021/05/13 06:00
PMCR- 2020/06/26
CRDT- 2020/06/27 06:00
PHST- 2020/03/09 00:00 [received]
PHST- 2020/05/10 00:00 [accepted]
PHST- 2020/06/27 06:00 [entrez]
PHST- 2020/06/27 06:00 [pubmed]
PHST- 2021/05/13 06:00 [medline]
PHST- 2020/06/26 00:00 [pmc-release]
AID - S2473-9529(20)31614-1 [pii]
AID - 2020/ADV2020001837 [pii]
AID - 10.1182/bloodadvances.2020001837 [doi]
PST - ppublish
SO  - Blood Adv. 2020 Jul 14;4(13):2871-2883. doi: 10.1182/bloodadvances.2020001837.