HYBRID EVENT: You can participate in person at London, UK or Virtually from your home or work.
ICC 2023

Fan Yang

 Fan Yang, Speaker at Oncology Conference
Beijing Gobroad Boren Hospital, China
Title : Efficacy and toxicity for CD7 chimeric antigen receptor T- Cell therapy in patients with relapsed/refractory T- Cell lymphoma

Abstract:

Background: The prognosis of refractory/relapsed T-cell lymphoma is extremely poor, especially for the patients who failed to allogeneic hematopoietic stem cell transplantation(alloHSCT).

Aims: The aim was to assess humanize CD7 chimeric antigen receptor (CAR) T-cell safety and efficacy in patients with r/r T-cell lymphoma.

Methods: From August 2017 to December 2022, 20 patients were enrolled. The median age was35 (18-72) years old. The diagnosis included T cell lymphoblastic leukemia/lymphoma(T-LBL) (n=17) ?hepatosplenic T-cell lymphoma(HSTL,n=1)?monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL,n=1) and cutaneous T-cell lymphoma( CTCL?n=1).The disease status was progressive disease (PD)in all patients who failed to multi-line therapies, including autologous HSCT (n=5), and alloHSCT(n=9).Six patients(6/20, 30%)had central nervous system involvement.In order to further reduce the tumor burden, 8/20(40%) patients were treated with bridging therapy before CAR-T cell infusion. Before the trial, the expression of CD7 antigen in tumor tissue was positive confirmed by pathology. Infusion of donor-derived CD7 CAR-T cells in patients who have relapsed after alloHSCT, whereas infusion of autologous CAR-T cells in other patients.Patients received fludarabine and cyclophosphamide regimens before CAR-T cell infusion. The kinetics and function of CAR-T cells was monitored by quantitative PCR and flow cytometry. The efficacy was evaluated by PET-CT as well as bone marrow puncture after CAR-T infusion.

Results: The median CAR-T cells infused were 1×105/kg (range,0.06-34×105/kg ). For CAR T cell expansion,the peak time in vivo was on median 14(range,11-29) days after CAR-T cell infusion.The median peak kinetics of CAR-T cells in peripheral blood of individual patients measured by flow cytometry was 23.65(range,1.61-49)×106/L, which was no correlation with the number of CAR-T infused(P=0.0818) .Peak CAR-T amplification is also independent of whether CART cells are sufficiently donor-derived(P=0.4692). Levels of CAR-T cells were very low after the first 1 months postinfusion. The incidence of grade 3 cytokine release syndrome (CRS) was 15% (3/20), and the incidence of grade 1-2 neurotoxicity was 10% (2/20).Although CD7-positive normal T cells were depleted, CD7-negative T cells expanded in all patients.Seventeen patients had occurred cytopenias. Nine patients?9/20,45%?had prolonged cytopenias (1 month).Viremia occurred in 12/20(60%)patients. 2/20(10%) patient developed post transplant lymphoproliferative disorders(PTLD)associated with EBV infection.1/9(11%) patients after allogeneic HSCT were found to have grade IV aGVHD (intestinal) .

 Conclusion: Our study showed promising efficacy of CD7 CAR-T cell therapy in r/r T-cell lymphoma. CRS is       manageable.For patients who have relapsed after allogeneic transplantation, bridge second transplantation is       recommended if CD7 CAR-T therapy is effective

Watsapp