Article Search

Progression-free survival was improved in the tafa-len-R-CHOP group vs the R-CHOP with 2-year progression-free survival rates of 71·1vs 62·9% toxicity was higher with tafa-len-R-CHOP with a higher rate of fatal treatment-emergent adverse events, but more overall deaths the RCHOP arm. It is early to add Len taf because of toxicity esp with OS survival and deep response data being immature.

Another update demonstrated the superiority of polatuzumab vedotin plus R-CHOP (Pola-R-CHOP) over R-CHOP alone, with improved progression-free survival (PFS) (64% vs 59%). Overall survival (OS) was not statistically significant; however, the hazard ratio was 0.85, with greater benefit observed in high-risk patients.

Minimal residual disease (MRD) testing after two cycles of therapy and at the end of treatment predicted 2-year progression-free survival (PFS) (96% in MRD-negative patients vs 67% in MRD-positive patients). MRD status was more predictive of treatment outcomes than radiographic imaging in this patient population.

This gives more credence to the idea of avoiding bendamustine before CAR T therapy. Patients exposed to bendamustine had about a 20% lower overall response rate (ORR), 50% shorter progression-free survival (PFS) and >50% shorter overall survival (OS) compared to those who were bendamustine naive. Although other factors may also play a role here, these seem to be significant differences and should make it clear that one should not use this drug before pursuing CAR T therapy.

Good review of high-risk patients, showing that prophylactic high dose MTX did not have lower risk of CNS disease.