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Dual CAR-T Therapy Associated With High Remission in R/R B-Cell ALL
Patients with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (ALL) treated with tandem CAR-T cells that simultaneously target both CD19 and CD22 were more likely to experience a complete remission (CR) than those who received CD19 CAR-T treatment or sequential CD19 and CD22 CAR-T cells therapy.
However, to note, there was no significant difference in overall survival (OS) or leukemia-free survival (LFS) associated with the three strategies.
“To reduce the possibility of relapse due to CD19 antigen loss, sequential CD19 and CD22 and tandem CD19 and CD22 dual target CAR-T cells have been developed. However, the optimal combination strategy of target antigens for CAR-T cells is still uncertain,” wrote lead author Sining Liu, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, China, and co-authors.
Out of a total of 200 patients with R/R B-cell ALL screened in the study: 168 received single CD19 CAR-T therapy, 49 received tandem CD19 and CD22 CAR-T therapy, and 13 received sequential CD19 and CD22 CAR-T cells.
Tandem CD19 and CD22 CAR-T therapy remained one of the significant favorable factors in multivariate logistic regression analysis of CR rate in all patients (HR, 0.081; 95% CI, 0.010-0.671). The CR rates were 82.7% in patients who received CD19 CAR-T therapy, 95.9% in patients who received tandem CD19 and CD22 CAR-T therapy, and 69.2% in patients who received sequential therapy (P=0.012).
There was no significant difference in OS and LFS among the three groups (6-month OS: 83.1%, 90.0% and 88.9%, respectively, P=0.1620; 6-month LFS: 76.2%, 76.2% and 88.9%, respectively, P=0.8179).
Univariate and multivariate Cox regression analyses showed that a better LFS related to less frequent relapse, lower tumor burden, minimal residual disease-negative CR and bridging allogeneic hematopoietic stem cell transplantation.
