Real-world outcomes for young adult patients receiving CD19 CAR T-cell therapy Journal Article
| Authors: | Lust, H.; Schultz, L. M.; Kwon, S.; Roloff, G. W.; Aldoss, I.; Baggott, C.; John, S.; Rossoff, J. E.; McNerney, K. O.; Fabrizio, V. A.; Talano, J. A.; Moskop, A.; Curran, K. J.; Phillips, C. L.; Karras, N.; Baumeister, S. H. C.; Cooper, S. L.; Hermiston, M.; Satwani, P.; Qayed, M.; Raikar, S. S.; MacMillan, M.; Hall, E.; Nguyen, K.; Cassaday, R. D.; Kopmar, N. E.; Kota, V. K.; Mathews, J.; Shaughnessy, P.; Schwartz, M. S.; Ladha, A.; Yaghmour, G.; Kumaran, M. V.; Bachanova, V.; Tracy, S.; Othman, T.; Luskin, M. R.; Chen, E. C.; Advani, A. S.; Jeyakumar, N.; Miller, K.; Zhang, A.; Sutherland, K. C.; Shah, B. D.; Muffly, L.; Faramand, R. |
| Article Title: | Real-world outcomes for young adult patients receiving CD19 CAR T-cell therapy |
| 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. © 2025 American Society of Hematology. Published by Elsevier Inc. All other rights reserved. |
| Keywords: | adult; young adult; human cell; major clinical study; overall survival; neutropenia; drug efficacy; drug safety; flow cytometry; neurotoxicity; outcome assessment; reverse transcription polymerase chain reaction; bone marrow; cohort analysis; relapse; cyclophosphamide; retrospective study; acute lymphoblastic leukemia; central nervous system; minimal residual disease; leukocyte count; cd19 antigen; recurrence free survival; cytokine release syndrome; high throughput sequencing; blinatumomab; disease burden; human; male; female; article; tisagenlecleucel t; chimeric antigen receptor t-cell immunotherapy; chimeric antigen receptor immunotherapy; brexucabtagene autoleucel |
| Journal Title: | Blood Advances |
| Volume: | 9 |
| Issue: | 11 |
| ISSN: | 2473-9529 |
| Publisher: | American Society of Hematology |
| Date Published: | 2025-06-10 |
| Start Page: | 2763 |
| End Page: | 2772 |
| Language: | English |
| DOI: | 10.1182/bloodadvances.2024014846 |
| PUBMED: | 40127395 |
| PROVIDER: | scopus |
| PMCID: | PMC12166372 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
