|The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
A patient’s minimal residual disease (MRD) status at day 28 after anti-CD19 chimeric antigen receptor (CAR) T-cell (CAR-T) therapy for relapsed or refractory diffuse large B-cell lymphoma (DLBCL) was significantly associated with progression-free survival and overall survival, according to a poster presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting.
MRD helped identify “early at-risk patients prior to progression,” according to the researchers, and provides a rationale for designing MRD-based risk-adaptive CAR-T clinical trials.
The study enrolled 50 patients with relapsed or refractory DLBCL undergoing CAR-T therapy with axicabtagene ciloleucel. MRD was measured prior to therapy and on days 0, 7, 14, 21, 28, 56, 90, 180, 270, and 365 after infusion. Twenty-four patients had 3 or more months of follow-up and the treatment circulating tumor DNA (ctDNA) MRD was significantly associated with clinical outcomes.
Of these 24 patients, 12 tested as MRD positive and 12 as MRD negative at the 28-day landmark analysis. The majority of the MRD-positive patients (10 of 12) experienced disease progression; whereas, only 2 of the MRD-negative patients progressed. Ten of the 12 MRD negative patients remain in complete remission.
After a median follow-up of 237 days, the median progression-free survival was significantly better in patients who were MRD negative at day 28 (not reached vs 93 days; P =.0010). Similarly, patients who were found to be MRD negative had significantly better overall survival as well (not reached vs 281 days; P =.0399).
Read more of Cancer Therapy Advisor‘s coverage of ASCO’s annual meeting by visiting the conference page.
Frank MJ, Hossain NM, Bukhari AA, et al. Monitoring ctDNA in r/r DLBCL patients following the CAR T-cell therapy axicabtagene ciloleucel: Day 28 landmark analysis. Presented at: American Society of Clinical Oncology (ASCO) Annual Meeting; May 31-June 4, 2019. Abstract 7552.