New CAR-T Therapy achieves positive results in a high proportion of patients with a refractory type of lymphoma

Rákkutatás · Hodgkin lymphoma

A Phase I trial involving ten patients with relapsed or refractory classical Hodgkin lymphoma or T‑cell lymphoma has achieved a 100% overall response rate and a 50% complete remission rate, in addition to a favourable safety profile and high in vivo persistence of CAR30+ cells.

Outcomes in older patients with Hodgkin lymphoma (HL) are compromised by the interplay of patient frailty and disease aggressiveness; however, current stratification tools, including the International Prognostic Score (IPS) and Comprehensive Geriatric Assessment (CGA), lack sufficient prognostic discrimination in the older HL population. We developed and validated a prognostic model integrating metabolic tumor burden and geriatric assessment. In this retrospective study across 14 centers in China between 2006 and 2024, we enrolled 306 patients aged ≥ 60 years with histologically confirmed HL. Patients were randomly partitioned into training (n = 250) and validation (n = 56) cohorts. Among the 306 patients, 98 deaths and 130 progression events were recorded during follow‑up. We analyzed 21 candidate variables. The least absolute shrinkage and selection operator (LASSO) analysis and multivariable Cox regression identified five independent predictors for 5‑year overall survival (OS): age > 73 years, baseline 18F‑FDG PET/CT‑derived total lesion glycolysis (TLG) > 200, hemoglobin ≤ 101 g/L, activities of daily living (ADL) dependence, and lymphocyte‑depleted classical Hodgkin lymphoma (LDCHL). A weighted Geriatric Risk Score stratified patients into low‑, intermediate‑, and high‑risk groups. In the validation cohort, the Geriatric Risk Score showed higher discriminatory accuracy than the CGA for both OS (C‑index, 0.770 [95% CI, 0.674‑0.867] vs. 0.671 [0.581‑0.762]) and PFS (0.761 [0.668‑0.853] vs. 0.635 [0.535‑0.735]). Among advanced‑stage (Ann Arbor stage III–IV) patients, it also outperformed the IPS 7 and IPS 3. By integrating metabolic tumor burden and geriatric assessment, the Geriatric Risk Score improves risk stratification over existing tools in older patients with HL.

The study demonstrates that a CD30‑directed CAR‑T therapy can produce complete responses in all treated patients, with durable remissions and manageable toxicity, offering a promising new option for patients with refractory Hodgkin lymphoma and other CD30‑positive lymphomas.

Bizonyítékszint: Számítógépes vagy elméleti. Modellből vagy adatbányászatból származó jel.

Eredeti forrás

Kapcsolódó jelek