Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma

Abstract Potential CD19 antigen loss following CD19-directed therapy has raised concerns over sequential use of these therapies. Tafasitamab, a CD19-targeting immunotherapy, combined with lenalidomide, is approved for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) treatment in adul...

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Main Authors: Narendranath Epperla, Loretta J. Nastoupil, Bruce Feinberg, John Galvin, Prathamesh Pathak, Theresa Amoloja, Danielle Gentile, Kim Saverno
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Biomarker Research
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Online Access:https://doi.org/10.1186/s40364-024-00706-6
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author Narendranath Epperla
Loretta J. Nastoupil
Bruce Feinberg
John Galvin
Prathamesh Pathak
Theresa Amoloja
Danielle Gentile
Kim Saverno
author_facet Narendranath Epperla
Loretta J. Nastoupil
Bruce Feinberg
John Galvin
Prathamesh Pathak
Theresa Amoloja
Danielle Gentile
Kim Saverno
author_sort Narendranath Epperla
collection DOAJ
description Abstract Potential CD19 antigen loss following CD19-directed therapy has raised concerns over sequential use of these therapies. Tafasitamab, a CD19-targeting immunotherapy, combined with lenalidomide, is approved for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) treatment in adults ineligible for autologous stem cell transplantation. This retrospective analysis examined characteristics and outcomes of adults with R/R DLBCL who received tafasitamab preceding CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy in a real-world setting. Nine patients received tafasitamab and lenalidomide immediately preceding CAR-T. Median (first quartile [Q1]–third quartile [Q3]) follow-up time since tafasitamab initiation was 26.1 (18.0–28.0) and after CAR-T was 9.3 (1.9–16.7) months. Of the 9 patients, 4 had complete response, 4 had partial response, and 1 had stable disease following tafasitamab; all discontinued tafasitamab due to disease progression. Median (Q1–Q3) tafasitamab therapy duration was 11.0 (8.1–14.1) months. Three patients had CD19 testing following tafasitamab discontinuation, and all tests were positive. Median (Q1–Q3) time from tafasitamab discontinuation to CD19 testing was 7 (6–9) days. Among the 9 patients, median (Q1–Q3) time from tafasitamab discontinuation to CAR-T administration was 3.2 (2.3–3.6) months. Four patients had complete response, 3 had partial response, and 1 had progressive disease as best response to CAR-T; 1 patient had data unavailable. This small real-world analysis demonstrated disease response to CAR-T therapy and detectable CD19 expression following tafasitamab treatment, adding to literature investigating treatment outcomes associated with sequential use of anti-CD19 therapies in patients with R/R DLBCL.
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series Biomarker Research
spelling doaj-art-415460a9c4954cd49ab3b8ae50d281652025-01-26T12:45:42ZengBMCBiomarker Research2050-77712025-01-011311510.1186/s40364-024-00706-6Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphomaNarendranath Epperla0Loretta J. Nastoupil1Bruce Feinberg2John Galvin3Prathamesh Pathak4Theresa Amoloja5Danielle Gentile6Kim Saverno7Huntsman Cancer Institute, University of UtahThe University of Texas MD Anderson Cancer CenterCardinal HealthIncyte CorporationCardinal HealthIncyte CorporationCardinal HealthIncyte CorporationAbstract Potential CD19 antigen loss following CD19-directed therapy has raised concerns over sequential use of these therapies. Tafasitamab, a CD19-targeting immunotherapy, combined with lenalidomide, is approved for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) treatment in adults ineligible for autologous stem cell transplantation. This retrospective analysis examined characteristics and outcomes of adults with R/R DLBCL who received tafasitamab preceding CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy in a real-world setting. Nine patients received tafasitamab and lenalidomide immediately preceding CAR-T. Median (first quartile [Q1]–third quartile [Q3]) follow-up time since tafasitamab initiation was 26.1 (18.0–28.0) and after CAR-T was 9.3 (1.9–16.7) months. Of the 9 patients, 4 had complete response, 4 had partial response, and 1 had stable disease following tafasitamab; all discontinued tafasitamab due to disease progression. Median (Q1–Q3) tafasitamab therapy duration was 11.0 (8.1–14.1) months. Three patients had CD19 testing following tafasitamab discontinuation, and all tests were positive. Median (Q1–Q3) time from tafasitamab discontinuation to CD19 testing was 7 (6–9) days. Among the 9 patients, median (Q1–Q3) time from tafasitamab discontinuation to CAR-T administration was 3.2 (2.3–3.6) months. Four patients had complete response, 3 had partial response, and 1 had progressive disease as best response to CAR-T; 1 patient had data unavailable. This small real-world analysis demonstrated disease response to CAR-T therapy and detectable CD19 expression following tafasitamab treatment, adding to literature investigating treatment outcomes associated with sequential use of anti-CD19 therapies in patients with R/R DLBCL.https://doi.org/10.1186/s40364-024-00706-6CAR-TCD19Chimeric antigen receptor T-cellR/R DLBCLReal-world studyTafasitamab
spellingShingle Narendranath Epperla
Loretta J. Nastoupil
Bruce Feinberg
John Galvin
Prathamesh Pathak
Theresa Amoloja
Danielle Gentile
Kim Saverno
Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma
Biomarker Research
CAR-T
CD19
Chimeric antigen receptor T-cell
R/R DLBCL
Real-world study
Tafasitamab
title Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma
title_full Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma
title_fullStr Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma
title_full_unstemmed Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma
title_short Real-world use of tafasitamab preceding CD19-directed chimeric antigen receptor T-cell therapy for relapsed or refractory diffuse large B-cell lymphoma
title_sort real world use of tafasitamab preceding cd19 directed chimeric antigen receptor t cell therapy for relapsed or refractory diffuse large b cell lymphoma
topic CAR-T
CD19
Chimeric antigen receptor T-cell
R/R DLBCL
Real-world study
Tafasitamab
url https://doi.org/10.1186/s40364-024-00706-6
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