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Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Tuesday, January 21, 2025
Saar Gill, MD, PhD, of the University of Pennsylvania, Philadelphia, and colleagues conducted a landmark analysis to investigate the long-term outcomes of a large cohort of patients who demonstrated at least 1 year of response after undergoing CD19-directed chimeric antigen receptor (CAR) T-cell therapy for relapsed or refractory chronic lymphocytic leukemia (CLL). Based on the findings presented during the 2024 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 588), despite having poor prognoses at the time of treatment, a significant subset seemed to have been cured.
“We and others have reported remarkably durable responses to CAR T-cell therapy, with several patients remaining disease-free without additional treatment for over 10 years,” the investigators remarked. “However, long-term outcomes [were only] available for a limited number of patients.”
The investigators focused on patients who received CAR T-cell therapy in a clinical trial (ClinicalTrials.gov identifier NCT01747486: n = 14 with monotherapy; NCT02640209: n = 17 with concurrent ibrutinib) and achieved a partial response or better for at least 1 year. Follow-up data were provided for a median of 6.5 years.
At 5 years after infusion, the progression-free survival rate was 57.1% with monotherapy and 64.7% with concurrent ibrutinib. The 5-year overall survival rates were 78.6% and 70.6%, respectively. Neither the median progression-free nor overall survival had been reached in either group. A total of 77.4% of patients remained progression-free at the time of last follow-up, with 79.1% of this population providing more than 5 years of data. No relapses were documented in those who were progression-free at 4 years.
In the first year after infusion, 71% were in complete response; a total of 29% of the population had less than a complete response. Both overall survival (P = .014) and progression-free (P = .046) survival were found to be significantly higher in patients with vs with less than a complete response.
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
2024 ASH Annual Meeting & Exposition
