Late Failure of Aggressive B-Cell Lymphoma After CAR T-Cell Therapy: New Insights and Findings

Strategic Insights -

Researchers at the University Hospital of Lyon in France have made a significant discovery regarding the treatment of aggressive B-cell lymphoma using CAR T-cell therapy. A study published in the journal Blood Advances found that patients who experience late failure after CAR T-cell therapy have a poor prognosis, with most progressions or relapses occurring within three months of infusion.

Key Takeaways:

  • The study analyzed data from 298 patients with late failure after CAR T-cell therapy, with a median age of 62 years and 61.7% being male.
  • Most patients had diffuse large B-cell lymphoma (DLBCL), advanced stage disease, and an age-adjusted International Prognostic Index (aaIPI) of 2-3 at CAR T eligibility.
  • After failure, 76.5% of patients received systemic therapy, with an overall response rate (ORR) of 22.6% (complete response 18%).
  • The median progression-free survival (PFS-2) and overall survival (OS-2) were 4.4 months and 13.2 months, respectively.
  • Salvage treatment with bispecific antibodies (BsAb) after CAR T failure showed better PFS-2 compared to chemotherapy and pooled other treatment groups.
  • Radiotherapy obtained prolonged responses in some patients, with a 12-month PFS-2 of 41.5%.

Statistics:

  • 298 patients with late failure after CAR T-cell therapy were analyzed.
  • 39.9% of patients had late failure.
  • 68.8% of patients had diffuse large B-cell lymphoma (DLBCL).
  • 84.6% of patients had advanced stage disease.
  • 59.3% of patients had an age-adjusted International Prognostic Index (aaIPI) of 2-3.
  • 76.5% of patients received systemic therapy after failure.
  • 22.6% of patients had an overall response rate (ORR) to salvage treatment.
  • 18% of patients had a complete response to salvage treatment.
  • 4.4 months was the median progression-free survival (PFS-2).
  • 13.2 months was the median overall survival (OS-2).
  • 41.5% of patients had a prolonged response to radiotherapy.

Sources:

  • Blood Advances, 2025.
  • University Hospital of Lyon, Lyon, France.
  • Emmannuel Bachy, University Hospital of Lyon and Universite Claude Bernard Lyon 1, Lyon, France.
  • Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands.