Outcomes of subsequent antilymphoma therapies after second-line axicabtagene ciloleucel or standard of care in ZUMA-7 Journal Article


Authors: Ghobadi, A.; Munoz, J.; Westin, J. R.; Locke, F. L.; Miklos, D. B.; Rapoport, A. P.; Perales, M. A.; Reagan, P. M.; McGuirk, J.; Jacobson, C. A.; Kersten, M. J.; Avivi, I.; Peng, A.; Schupp, M.; To, C.; Oluwole, O. O.
Article Title: Outcomes of subsequent antilymphoma therapies after second-line axicabtagene ciloleucel or standard of care in ZUMA-7
Abstract: The optimal management of patients with relapsed/refractory large B-cell lymphoma (LBCL) after disease progression or lack of response to second-line (2L) therapy remains unclear. Here, we report outcomes among patients who received subsequent antilymphoma therapy per investigator discretion separately by their randomized 2L arm in ZUMA-7, namely axicabtagene ciloleucel (axi-cel) vs standard of care (SOC). Progression-free survival (PFS) and overall survival (OS) were calculated from 3L therapy initiation. In the SOC arm, 127 of 179 randomized patients (71%) received 3L therapy. Median PFS among those who received 3L cellular immunotherapy (n = 68) vs those who did not (n = 59) was 6.3 vs 1.9 months, respectively; median OS was 16.3 vs 9.5 months, respectively. In the axi-cel arm, 84 of 180 randomized patients (47%) received 3L therapy. Median PFS among those who received 3L chemotherapy (n = 60) vs cellular immunotherapy (n = 8) was 1.7 vs 3.5 months, respectively; median OS was 8.1 months vs not reached, respectively. Of the 60 patients who received 3L chemotherapy, 10 underwent stem cell transplantation (SCT) after salvage chemotherapy. Median PFS was 11.5 vs 1.6 months, and median OS was 17.5 vs 7.2 months for those who did vs did not reach SCT, respectively. Eight patients received 3L cellular immunotherapy after 2L axi-cel. Of these, 6 patients received subsequent SCT in any line; all 6 were alive at data cutoff. These findings help inform subsequent treatment choices after 2L therapy failure for relapsed/refractory LBCL. © 2024 by The American Society of Hematology.
Keywords: controlled study; treatment outcome; treatment failure; major clinical study; overall survival; rituximab; outcome assessment; follow up; progression free survival; radiation; randomized controlled trial; steroid; stem cell transplantation; histology; lymphoma; chimeric antigen receptor; cell therapy; disease exacerbation; leukapheresis; apheresis; second-line treatment; diffuse large b cell lymphoma; palliative chemotherapy; cellular immunotherapy; human; article; polatuzumab vedotin; disease assessment; axicabtagene ciloleucel; antineoplastic protocol
Journal Title: Blood Advances
Volume: 8
Issue: 11
ISSN: 2473-9529
Publisher: American Society of Hematology  
Date Published: 2024-06-11
Start Page: 2982
End Page: 2990
Language: English
DOI: 10.1182/bloodadvances.2023011532
PUBMED: 38315832
PROVIDER: scopus
PMCID: PMC11302377
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Miguel-Angel Perales
    913 Perales