Anti-CD19 chimeric antigen receptor (CAR) T-cell immunotherapies improve hospitalization and infection rates as well as three-year survival compared with historical care for patients with relapsed or refractory large B-cell lymphoma (LBCL) after two lines of systemic therapy, according to a paper in Blood Advances by a group of researchers affiliated with the University of Toronto in Ontario, Canada.
The retrospective, single-center cohort study used linked data from the Princess Margaret Cancer Centre lymphoma database and population-based administrative and cancer registry datasets housed at the Institute for Clinical Evaluative Sciences, an independent research body that collects and analyses Ontario healthcare data.
The researchers used propensity-weighted analysis to compare three-year survival, healthcare resource use, and hospitalization events for patients with relapsed or refractory-LBCL treated with CAR-T (n=85) vs historical controls (HCs) treated before CAR-T approval who would have been eligible based on present criteria (n=150).
In terms of survival, for the CAR-T group the three-year overall survival (OS) was 59%, progression-free survival was 48%, and the hazard ratio for OS was 0.21, while for the HC group, the figures were 10%, 6% and 0.28, respectively.
Per 1,000 person-days at risk, patients receiving CAR-T had fewer hospital admissions than HCs (5.32 vs 9.1), emergency visits (2.33 vs 4.81), and intensive care admissions (0.53 vs 1.25), plus lower hospitalization rates for fever (0.93 vs 1.63), infection (1.48 vs 3.08), and neutropenia (0.66 vs 1.97; all P < .001).
“CAR-T produced a sustained survival benefit, and, despite well-described CAR-T toxicities, HCs experienced more hospitalization events, underscoring the lack of effective salvage treatments,” the researchers wrote. “As one of the largest real-world comparisons of patients with R/R-LBCL receiving CAR-T vs previous standard of care, this study demonstrated its improved effectiveness and reduced healthcare resource use.”
