Article
作者: Sutherland, Katherine C. ; Faramand, Rawan ; Miller, Katharine ; Roloff, Gregory W. ; Mathews, John ; Qayed, Muna ; Baumeister, Susanne H.C. ; Satwani, Prakash ; Rossoff, Jenna E. ; Ladha, Abdullah ; Luskin, Marlise R. ; Zhang, Amy ; Kopmar, Noam E. ; Phillips, Christine L. ; Aldoss, Ibrahim ; Cooper, Stacy L. ; Jeyakumar, Nikeshan ; Fabrizio, Vanessa A. ; Baggott, Christina ; Raikar, Sunil S. ; Curran, Kevin J. ; Yaghmour, George ; Schultz, Liora M. ; Schwartz, Marc S. ; McNerney, Kevin O. ; MacMillan, Margaret ; Kota, Vamsi K. ; Chen, Evan C. ; Hall, Erin ; Kwon, Soyang ; Muffly, Lori ; Kumaran, Muthu V. ; Cassaday, Ryan D. ; Talano, Julie-An ; Advani, Anjani S. ; Nguyen, Khanh ; Bachanova, Veronika ; John, Samuel ; Shah, Bijal D. ; Tracy, Sean ; Othman, Tamer ; Shaughnessy, Paul ; Lust, Hannah ; Karras, Nicole ; Moskop, Amy ; Hermiston, Michelle
Abstract:Tisagenlecleucel (tisa-cel) and brexucabtagene autoleucel (brexu-cel) are approved CD19 chimeric antigen receptor T-cell therapy (CAR T) products for young adults (YA) with relapsed/refractory B-cell acute lymphoblastic leukemia. A distinct analysis of YAs receiving commercial CD19 CAR T has not been reported. Using retrospective data from the Pediatric Real-World CAR T Consortium and the Real-World Outcomes of CAR T in Adult ALL collaboration, we describe the efficacy and safety of tisa-cel and brexu-cel in 70 YAs (18-26 years; tisa-cel, n = 50; brexu-cel, n = 20). Cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS) were observed more frequently for brexu-cel vs tisa-cel (CRS, 85% vs 56%; ICANS, 40% vs 18%). Complete response rates were similar between products at 80% for brexu-cel and 88% for tisa-cel. Relapse-free survival (RFS) at 12 months was 46% for brexu-cel and 36% for tisa-cel. Durability of remission over 12 months was 61% for brexu-cel vs 41% for tisa-cel; 12-month overall survival (OS) for brexu-cel was 84% vs 68% for tisa-cel. In multivariate analysis, low disease burden was associated with improved OS, whereas inotuzumab before CAR T was associated with inferior outcomes. This study demonstrates comparable real-world efficacy among YAs receiving CD19 CAR T irrespective of CAR T construct; however, rates of toxicity seem higher with brexu-cel.