Impact of prior inotuzumab ozogamicin treatment on brexucabtagene autoleucel outcomes in adults with B-cell ALL.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Aldoss Ibrahim, Roloff Gregory W, Faramand Rawan, Kopmar Noam E, Lin Chenyu, Advani Anjali S, Dekker Simone E, Gupta Vishal K, O'Connor Timothy E, Jeyakumar Nikeshan, Muhsen Ibrahim N, Valtis Yannis, Zhang Amy, Miller Katharine, Sutherland Katherine, Dykes Kaitlyn C, Ahmed Mohamed, Chen Evan, Zambrano Hector, Bradshaw Danielle, Mercadal Santiago, Schwartz Marc, Tracy Sean, Dholaria Bhagirathbhai, Kubiak Michal, Mukherjee Akash, Majhail Navneet, Battiwalla Minoo, Mountjoy Luke, Malik Shahbaz A, Mathews John, Shaughnessy Paul, Logan Aaron C, Ladha Abdullah, Stefan Maryann, Guzowski Caitlin, Hoeg Rasmus T, Hilal Talal, Moore Jozal, Connor Matthew, O'Dwyer Kristen M, Hill LaQuisa C, Tsai Stephanie B, Sasine Joshua, Solh Melhem M, Lee Catherine J, Kota Vamsi K, Koura Divya, Veeraputhiran Muthu, Blunk Betsy, Oliai Caspian, Leonard Jessica T, Frey Noelle V, Park Jae H, Luskin Marlise R, Bachanova Veronika, Galal Ahmed, Bishop Michael R, Stock Wendy, Cassaday Ryan D, Pullarkat Vinod, Shah Bijal D, Muffly Lori S
Аннотация
The effect of prior inotuzumab ozogamicin (InO) treatment on brexucabtagene autoleucel (brexu-cel) outcomes remains unclear in adults with acute lymphoblastic leukemia (ALL). We conducted a retrospective multicenter analysis of 189 patients with relapsed/refractory ALL treated with brexu-cel. Over half of the patients received InO before brexu-cel (InO exposed). InO-exposed patients were more heavily pretreated (P = .02) and frequently had active marrow disease before apheresis (P = .03). Response rate and toxicity profile after brexu-cel were comparable for InO-exposed and InO-naïve patients; however, consolidation therapy after brexu-cel response was used at a higher rate in InO-naïve patients (P = .005). With a median follow-up of 11.4 months, InO-exposed patients had inferior progression-free survival (PFS; P = .013) and overall survival (OS; P = .006) in univariate analyses; however, prior InO exposure did not influence PFS (hazard ratio, 1.20; 95% confidence interval, 0.71-2.03) in multivariate models. Within InO-exposed patients, InO responders had superior PFS (P = .002) and OS (P < .0001) relative to InO-refractory patients. The timing of administering InO did not affect brexu-cel outcomes, with comparable PFS (P = .51) and OS (P = .86) for patients receiving InO as bridging therapy or before apheresis. In conclusion, although InO exposure was associated with inferior survival outcomes after brexu-cel in unadjusted analyses, these associations were no longer significant in multivariate analyses, suggesting it is unlikely that InO negatively affects brexu-cel efficacy. Our data instead imply that InO-exposed recipients of brexu-cel tend to be higher-risk patients with intrinsic adverse leukemia biology.