Yan Leyfman: New CIBMTR Analysis
Yan Leyfman, Medical Oncologist, Co-Founder and Executive Director of MedNews Week, shared on X about a recent paper by Jordan Gauthier et al. published on AJH:
“New CIBMTR Analysis: CD19 CAR T in Primary Mediastinal B-Cell Lymphoma (PMBCL)
CD19-directed CAR T-cell therapy is standard for high-risk R/R LBCL — but what about rare PMBCL? This multi-center registry study sheds light.
Cohort: 135 adults, 66 centers
Median age: 32 years
28.9% received immune checkpoint inhibitor (ICI) prior to CAR T
Efficacy:
- Overall response rate (ORR): 79%
- Complete response (CR): 67.7%
- 2-year PFS: 58.6% (95% CI 49.7–67.3)
- 2-year OS: 80.8% (95% CI 72.6–87.8)
Toxicity:
- Grade ≥3 CRS: 6.1%
- Grade ≥3 ICANS: 14.7%
- 2-year NRM: 5.4%
Impact of Prior ICI Exposure:
- Relapse risk lower: 21.7% vs 41.6% (p=0.03)
- NRM higher: 11.7% vs 2.8% (p=0.03)
- No statistically significant PFS (p=0.19) or OS (p=0.26) difference
Key Takeaway:
CD19 CAR T achieves high, durable responses with low severe toxicity rates in PMBCL. Prior ICI may lower relapse risk but could increase NRM – an important balance to weigh in treatment planning.”
Title: CD19 CAR T-Cell Therapy for Primary Mediastinal Large B-Cell Lymphoma: A CIBMTR Analysis
Authors: Jordan Gauthier, Kwang W. Ahn, Jinalben Patel, Qinghua Lian, Sherif Badawy, Mitchell S. Cairo, Julio Delgado, Natalie Grover, Bradley Haverkos, Marcos de Lima, Adriana Malone, Alberto Mussetti, Yago Nieto, Attaphol Pawarode, Laurie Pearson, Melhem Solh, Anna Sureda, Aung M. Tun, Kitsada Wudhikarn, Samuel Yamshon, Mazyar Shadman, Cameron J. Turtle, Mehdi Hamadani, Alex F. Herrera
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