scholarly journals Matching-adjusted indirect treatment comparison of liso-cel versus axi-cel in relapsed or refractory large B cell lymphoma

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
David G. Maloney ◽  
John Kuruvilla ◽  
Fei Fei Liu ◽  
Ana Kostic ◽  
Yeonhee Kim ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Odds Ratio ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Sensitivity Analyses ◽  
Efficacy And Safety ◽  
Bridging Therapy ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Background In the absence of randomized studies directly comparing chimeric antigen receptor T cell therapies, this study used matching-adjusted indirect comparisons (MAIC) to evaluate the comparative efficacy and safety of lisocabtagene maraleucel (liso-cel) versus axicabtagene ciloleucel (axi-cel) in patients with relapsed or refractory large B cell lymphoma (LBCL). Methods Primary data sources included individual patient data from the TRANSCEND NHL 001 study (TRANSCEND [NCT02631044]; N = 256 for efficacy set, N = 269 for safety set) for liso-cel and summary-level data from the ZUMA-1 study (NCT02348216; N = 101 for efficacy set, N = 108 for safety set) for axi-cel. Inter-study differences in design, eligibility criteria, baseline characteristics, and outcomes were assessed and aligned to the extent feasible. Clinically relevant prognostic factors were adjusted in a stepwise fashion by ranked order. Since bridging therapy was allowed in TRANSCEND but not ZUMA-1, the initial efficacy and safety analyses included bridging therapy use as a matching factor (TRANSCEND patients who received bridging therapy were removed). Subsequent sensitivity analyses excluded this matching factor. Results The initial analysis showed similar MAIC-weighted efficacy outcomes between TRANSCEND and ZUMA-1 for overall and complete response rates (odds ratio [95% confidence interval (CI)], 1.40 [0.56–3.49] and 1.21 [0.56–2.64], respectively) and for overall survival and progression-free survival (hazard ratio [95% CI], 0.81 [0.44–1.49] and 0.95 [0.58–1.57], respectively). MAIC-weighted safety outcomes favored liso-cel, with significantly lower odds of all-grade and grade ≥ 3 cytokine release syndrome (odds ratio [95% CI], 0.03 [0.01–0.07] and 0.08 [0.01–0.67], respectively) and study-specific neurological events (0.16 [0.08–0.33] and 0.05 [0.02–0.15], respectively). Efficacy and safety outcomes remained similar in sensitivity analyses, which did not include use of bridging therapy as a matching factor. Conclusions After matching and adjusting for clinically relevant prognostic factors, liso-cel demonstrated comparable efficacy and a more favorable safety profile compared with axi-cel in patients with third- or later-line relapsed or refractory LBCL. Trial registration: NCT02631044 and NCT02348216

Importance of Relative Dose Intensity for Survival in Diffuse Large B-Cell Lymphoma Patients Treated with CHOP-Like Regimen

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3605-3605
Author(s):  
Tsuneaki Hirakawa ◽  
Hiroki Yamaguchi ◽  
Seiji Gomi ◽  
Norio Yokose ◽  
Koiti Inokuchi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Odds Ratio ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Relative Dose Intensity ◽  
Large B Cell Lymphoma ◽  
Prophylactic Use ◽  
Large B Cell

Abstract Diffuse large B-cell lymphoma (DLBCL) is the most frequently occurring Non-Hodgkin lymphoma (NHL). Until recently, CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone delivered on a 21-day cycle) was considered as the standard chemotherapy regimen for DLBCL. Recent data have also shown that combining CHOP with Rituximab (R-CHOP) significantly improves survival in DLBCL. It is recognized that delivery of less than full-dose chemotherapy is associated with poor response and shorter survival times. However it is difficult to keep administration of chemotherapy dose and interval due to several side effects such as myelosuppression, infection, and organ dysfunction. Recently relative dose intensity (RDI) defined as total delivered dose of chemotherapy drug per unit time expressed as a percentage of the target dose, had important roll in the treatment outcome. To determine the importance of RDI, we analyzed achievement of RDI in CHOP-like regimen among DLBCL patients. We retrospectively analyzed 203 DLBCL patients treated with CHOP-like regimen as a first line therapy at Nippon Medical School Hospital and related hospital between January 1, 1996 and December 31, 2007. Median age of the patients was 65.6 years (range, 20.5–90.3) at diagnosis. Median duration of observation was 1.9 years (range, 0.1–11.8). 203 patients were classified as international prognostic index (IPI) as follows; Low-Low Intermediate (L-LI) (n=116), High Intermediate-High (HI-H) (n=86), unknown (n=1). They were treated by CHOP (n=47), R-CHOP (n=100), THP (terahydropyranyladriamycin)-COP (n=6), R-THP-COP (n=50). The median RDI of all patients was 75.2%. Increasing RDI correlated with longer survival time (RDI of 70 to <75%, 75 to 79%, and ≥80%, mean survival was 4.6, 5.0 and 5.2 years, respectively). Comparing the patients of RDI ≥80% with those of <80%, the estimated relapse free survival (RFS) and overall survival (OS) was significantly higher in the former (RFS; 81.7% vs 66.4%, p=0.039, OS; 94.1% vs 74.3%, p=0.005). Results of a multivariate Cox regression analyses revealed that RDI of ≥80% (odds ratio 2.495, p=0.040), IPI of L-LI (odds ratio 3.459, p=0.006) and Rituximab (odds ratio 3.554, p=0.005) were independent prognostic factors for OS. Concerning RFS, IPI of L-LI (odds ratio 2.873, p=0.002) and Rituximab (odds ratio 1.989, p=0.044) were independent prognostic factors. On the other hand, RDI of ≥ 80% showed tendency to longer RFS, but it was not statistically significant (odds ratio 1.747, p=0.094). Subsequently we analyzed the reason for the dose reduction an/or chemotherapy delay. Among the reasons, hematological toxicities and febrile neutropenia (FN) resulted in a reduction of treatment intensity significantly (odds ratio 2.550, p=0.007). Prophylactic use of granulocyte colony-stimulating factor (G-CSF) decreased the risk of neutropenic complications and served as increasing the dose intensity (odds ratio 0.436, p=0.007). We demonstrated that increasing RDI was a important prognostic factor for treating DLBCL using CHOP-like regimen. Moreover, prophylactic use of G-CSF to decrease FN had important role for increasing RDI.

scholarly journals Receptor tyrosine kinases MET and RON as prognostic factors in diffuse large B-cell lymphoma patients receiving R-CHOP

2013 ◽  
Vol 104 (9) ◽  
pp. 1245-1251 ◽  
Author(s):  
Young Wha Koh ◽  
Hee Sang Hwang ◽  
Se Jin Jung ◽  
Chansik Park ◽  
Dok Hyun Yoon ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Tyrosine Kinases ◽  
Receptor Tyrosine Kinases ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals C-MYC Aberrations as Prognostic Factors in Diffuse Large B-cell Lymphoma: A Meta-Analysis of Epidemiological Studies

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e95020 ◽  
Author(s):  
Kuangguo Zhou ◽  
Danmei Xu ◽  
Yang Cao ◽  
Jue Wang ◽  
Yunfan Yang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Cell Lymphoma ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
Epidemiological Studies ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals New nomograms based on treatment outcome and prognostic factors for patients with spinal diffuse large B-cell lymphoma: A population‐based study

2020 ◽  
Author(s):  
Ben Wang ◽  
Lijie Chen ◽  
Boda Chen ◽  
Chenglong Xie ◽  
Zhenxuan Shao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Treatment Method ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Internal Validation ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Background: Spinal diffuse large B-cell lymphoma (DLBCL) was a rare and malignant tumor, while few studies researched the prognostic factors. The prognostic factors which might have impacts on spinal DLBCL was not clear. Although chemotherapy was recognized as an optimal treatment method, but the curative effect of radiotherapy and surgery were controversial. Methods: The records of patients with spinal DLBCL were selected from the SEER database from 1991 to 2016. The incidence obtained by database was analyzed by Joinpoint Regression Program. The optimal cut-off values of age and year of diagnosis were identified by X-tail program. Univariate and multivariate survival analysis were calculated to identify independent prognostic factors. Prognostic factors were included to predict the survival possibility compared with 5 years of overall (OS) and cancer-specific survival (CSS) via the new nomograms. Results: A total of 917 patients were enrolled. Age, year of diagnosis and chemotherapy were demonstrated as independent prognostic factors for CSS and OS, and primary site was another independent prognostic factor for CSS. However, radiotherapy and surgery might be ineffective in survival. All factors were included to generate the nomograms for CSS and OS. The concordance indices (C-index) for internal validation of OS and CSS prediction were 0.697 (95%CI: 0.662-0.732) and 0.709 (95%CI: 0.692- 0.727) respectively. Conclusions: Age and year of diagnosis are closely associated with the prognosis of spinal DLBCL, and chemotherapy is an ideal treatment modality. The new nomogram is a favourable tool to evaluate the survival possibility, and is benefit for the oncologist to make clinical decisions.

Clinical Efficacy and Safety in Relapsed/Refractory Diffuse Large B-Cell Lymphoma: A Systematic Literature Review

2014 ◽  
Vol 14 (5) ◽  
pp. 343-355.e6 ◽  
Author(s):  
Ann Colosia ◽  
Annete Njue ◽  
Peter C. Trask ◽  
Robert Olivares ◽  
Shahnaz Khan ◽  
...  
Keyword(s):  
Literature Review ◽  
B Cell ◽  
Clinical Efficacy ◽  
Systematic Literature Review ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Efficacy And Safety ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Osteopontin expression and its relationship with prognostic factors in diffuse large B-cell lymphoma

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Gilberto Barranco ◽  
Edith Fernández ◽  
Silvia Rivas ◽  
Roxana Quezada ◽  
Dolores Nava ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Germinal Center ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Cox Proportional Hazards ◽  
Biological Behavior ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

The aim of this study is to explore the expression of osteopontin (OPN) and its relationship with prognostic factors and survival in diffuse large B cell lymphoma (DLBCL). A tissue microarray was performed for immunohistochemical evaluation. Contingency tables were analyzed for trends; chi-square test was used to determine differences between groups. Univariate and multivariate Cox proportional hazards-regression analyses were performed to evaluate the impact of prognostic factors on survival. Expression of OPN was observed in 28%. It was different in non-germinal center DLBCL (P=0.04). The mean overall survival (OS) was lower in patients with positive OPN expression (19.762; CI 95% 14.269-25.255) it was not significant (P=0.123). It is not possible to establish a clear relationship between the expression by immunohistochemistry of osteopontin and a poor prognosis but it would be important to complement the analysis with other techniques as PCR or NGS that allow us to assess the influence of the isoforms and post-translational modifications of OPN on the biological behavior of DLBCL. Our findings indicate that OPN expression could be associated with a more aggressive variant of lymphoma: non-germinal center DLBCL.

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