Optimizing Real-World Outcomes in High-Risk Relapsed/Refractory (r/r) FL with CAR-T Cell Therapy: A Vodcast and Case Example.

IF 3.2 Q2 ONCOLOGY

Oncology and Therapy Pub Date : 2024-06-01 Epub Date: 2024-03-21 DOI:10.1007/s40487-024-00269-4

Kai Hübel

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引用次数: 0

Abstract

Follicular lymphoma (FL) is often considered a chronic disease with frequent relapses, shortening both response duration and survival after every relapse. Selecting the most appropriate therapy at the right time within the treatment timeline is key to optimize outcomes. The aim of this vodcast, featuring Dr. Kai Hübel, is to outline the severity of FL by referring to a patient case as well as highlight chimeric antigen receptor (CAR)-T cells as an effective therapy in relapsed/refractory (r/r) FL. The patient was in their early 50s, diagnosed with FL in the early 2010s and presented with a third relapse. The patient complained of night sweats and fatigue but was still capable of self-care (Eastern Cooperative Oncology Group Performance Status Scale 2). The patient received eight cycles of rituximab-cyclophosphamide-doxorubicin-vincristine-prednisolone (R-CHOP), followed by irradiation and rituximab maintenance (first-line) and then received rituximab 4 × weekly, followed by rituximab maintenance (second-line). The patient relapsed during rituximab maintenance; the patient was rituximab refractory. The patient received six cycles of bendamustine/obinutuzumab followed by obinutuzumab maintenance. The patient relapsed during obinutuzumab maintenance, achieved a partial remission after irradiation and was switched to R/lenalidomide. Due to several high-risk features, CAR-T cell therapy was initiated. Dr. Hubel underlines how earlier treatment with CAR-T cell therapy would have been beneficial for this patient. Results of the ELARA trial as well as comparative studies have shown tisagenlecleucel to be more effective than standard of care in extensively pretreated r/r FL, including high-risk patients. In conclusion, CAR-T cell therapy is a promising therapy option for patients with multiply r/r FL. A vodcast feature is available for this article.

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利用 CAR-T 细胞疗法优化高风险复发性/难治性 FL 的实际治疗效果：Vodcast 和案例。

滤泡性淋巴瘤（FL）通常被认为是一种慢性疾病，经常复发，每次复发后反应持续时间和生存期都会缩短。在治疗时限内的正确时间选择最合适的疗法是优化疗效的关键。本视频直播由 Kai Hübel 博士主讲，旨在通过一个患者病例概述 FL 的严重性，并强调嵌合抗原受体（CAR）-T 细胞是治疗复发/难治（r/r）FL 的有效疗法。患者50多岁，2010年初被诊断出患有FL，并出现了第三次复发。患者主诉盗汗和疲劳，但仍有自理能力（东部合作肿瘤学组表现状态量表 2）。患者接受了8个周期的利妥昔单抗-环磷酰胺-多柔比星-长春新碱-强的松龙（R-CHOP）治疗，随后接受了照射和利妥昔单抗维持治疗（一线），然后接受了每周4次的利妥昔单抗治疗，随后接受了利妥昔单抗维持治疗（二线）。患者在利妥昔单抗维持治疗期间复发；患者为利妥昔单抗难治性患者。患者接受了六个周期的苯达莫司汀/奥比妥珠单抗治疗，然后接受奥比妥珠单抗维持治疗。患者在奥比妥珠单抗维持治疗期间复发，在照射后获得部分缓解，并改用R/来那度胺治疗。由于出现了几种高风险特征，患者开始接受CAR-T细胞疗法。Hubel博士强调说，如果能尽早使用CAR-T细胞疗法，将对这名患者大有裨益。ELARA试验和对比研究的结果表明，对于广泛预处理的r/r FL患者（包括高危患者），tisagenlecleucel比标准疗法更有效。总之，CAR-T细胞疗法是治疗多发性r/r FL患者的一种很有前景的疗法。本文有视频播报功能。

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来源期刊

Oncology and Therapy ONCOLOGY-

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6 weeks

期刊介绍： Now indexed in PubMed Aims and Scope Oncology and Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Oncology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of clinical therapies. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts. Digital features and plain language summaries Oncology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. 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All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). 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