CAR-T Cell Therapy Shows Similar Efficacy and Toxicity in Patients With DLBCL Regardless of CNS Involvement

Evgenii Shumilov; Hristo Boyadzhiev; Paolo Mazzeo; Dilara Akhoundova; Michael Daskalakis; Urban Novak; Georg Lenz; Ulrike Bacher; Thomas Pabst

doi:10.1097/HS9.0000000000000984

CAR-T Cell Therapy Shows Similar Efficacy and Toxicity in Patients With DLBCL Regardless of CNS Involvement

Hemasphere. 2023 Nov 30;7(12):e984. doi: 10.1097/HS9.0000000000000984. eCollection 2023 Dec.

Authors

Evgenii Shumilov¹, Hristo Boyadzhiev², Paolo Mazzeo³, Dilara Akhoundova⁴, Michael Daskalakis⁵, Urban Novak⁴, Georg Lenz¹, Ulrike Bacher⁵, Thomas Pabst⁴

Affiliations

¹ Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster (UKM), Germany.
² Habichtswald Hospital, Kassel, Germany.
³ Clinics of Hematology and Medical Oncology, INDIGHO Laboratory, University Medical Center Göttingen (UMG), Germany.
⁴ Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
⁵ Department of Hematology, Inselspital, University Hospital Bern, University of Bern, Switzerland.

Abstract

Efficacy and toxicity of chimeric antigen receptor T (CAR-T) cell therapy in relapsed/refractory (r/r) diffuse large B-cell lymphoma (DLBCL) with central nervous system (CNS) involvement remain understudied. Here we analyzed the outcomes of CAR-T cell therapy in r/r DLBCL patients with CNS involvement and compared them with patients without CNS disease. Retrospective and monocentric comparative analysis of patient cohort with r/r DLBCL treated with CAR-T cell therapy: 15 patients with CNS versus 65 patients without CNS involvement. Overall response rates (80% versus 80%; P = 1.0), progression-free survival (P = 0.157), and overall survival (P = 0.393) were comparable for both cohorts. The frequency of cytokine release syndrome was comparable in the CNS and non-CNS cohorts; 93% versus 80%; P = 1.0. Numerically, immune effector-cell-associated neurotoxicity syndrome (all grades) was more frequent in patients with CNS manifestation (53% versus 29%; P = 0.063), although no grade 4 events were documented. Our study suggests that CAR-T cell therapy is effective and feasible in patients with r/r DLBCL and CNS manifestation.