CAR T-cell therapy improves survival in non-Hodgkin lymphoma

Treatment with chimeric antigen receptor T-cell therapies (CAR-TCT) results in significant improvements in overall (OS) and progression-free survival (PFS) among patients with refractory non-Hodgkin lymphoma (NHL) but shows no substantial effect on event-free survival (EFS), reports a study.

Researchers performed a literature search across PubMed, ScienceDirect, Google Scholar, and the Cochrane Library for studies on CAR-TCT in NHL treatment published until July 2024. They then assessed the OS, EFS, PFS, objective response rate (ORR), and adverse events (AEs). 

A total of 532 articles were identified, of which eight met the inclusion criteria.

CAR-TCT led to significant improvements in OS (hazard ratio [HR], 0.79, 95 percent confidence interval [CI], 0.63–1.00; p=0.05) and PFS (HR, 0.46, 95 percent CI, 0.36–0.58; p<0.00001) relative to standard chemotherapy. However, no significant difference was observed in EFS (HR, 0.54, 95 percent CI, 0.26–1.09; p=0.09).

Of the NHL patients, 76.6 percent responded to CAR-TCT. However, the ORR did not significantly differ between CAR-TCT and standard therapy (mean difference, 19.23, 95 percent CI, –11.34 to 49.80; p=0.22).

In safety analysis, the incidence of grade ≥3 AEs was similar between CAR-TCT and standard care, but the former was associated with a higher risk of neutropenia and lower risks of thrombocytopenia, anaemia, and nausea.

"NHL are a diverse group of lymphoproliferative malignancies, often more unpredictable than Hodgkin lymphomas, with a higher likelihood of extranodal spread,” the researchers said. “NHL’s resistance to standard chemotherapy has increased, leading to a growing interest in personalized treatments like CAR-TCT.”