Outcomes and salvage strategies for large B‐cell lymphoma progressing after second‐line CAR T‐cell therapy: A DESCAR‐T study from the LYSA group

作者：Pierre Sesques, Guillaume Manson, Guillaume Cartron, François‐Xavier Gros, Franck Morschhauser, Cristina Castilla‐Llorente, Gabriel Brisou, Pierre Bories, C Thieblemont, Laurianne Drieu La Rochelle, Benoît Tessoulin, Axel André, Cedric Rossi, Jérôme Paillassa, Stephanie Guidez, Antoine Capes, Laura Herbreteau, Sylvain Choquet, Jacques‐Olivier Bay, Adrien Chauchet, Laure Lebras, Fabien Claves, Julie Abraham, Jean‐Valère Malfuson, Marie‐Thérèse Rubio, Justine Decroocq, Luc‐Matthieu Fornecker, Gandhi Damaj, Ludovic Fouillet, Magalie Joris, Michael Loschi, Olivier Hermine, Hadia Hafirassou, Emelie Van Zele, Vivien Dupont, Steven Le Gouill, Roch Houot, Vincent Camus · 发表于：HemaSphere · 年份：2026 · DOI：10.1002/hem3.70356 · 研究领域：CAR-T cell therapy research、Lymphoma Diagnosis and Treatment、Cutaneous lymphoproliferative disorders research

Relapse after chimeric antigen receptor (CAR) T-cell therapy in large B-cell lymphoma (LBCL) is associated with a dismal prognosis. Although Phase 3 trials have established CAR T-cells as standard second-line (2L) therapy, outcomes and optimal management after relapse in this setting remain unknown because no real-world data are currently available. We conducted a multicenter retrospective study using the French DESCAR-T registry, including patients with LBCL who relapsed after 2L CAR T-cell therapy with axicabtagene ciloleucel or lisocabtagene maraleucel. The objective was to describe postrelapse treatments, outcomes, and prognostic factors. Among the 893 patients treated with 2L CAR T-cells, 297 (33%) relapsed and were analyzed. Median time to relapse was 2.7 months, with 35% of these relapses occurring within 2 months. Among the 231 treated patients, bispecific antibody (BsAb)-based regimens were the most common type of salvage therapy (65%). The overall response rate after relapse was 39.1%, with a complete response rate of 27.6%. Notably, despite the use of BsAb-based therapy in 65% of patients, the median overall survival (OS2) after relapse was only 6.5 months (median progression-free survival [PFS2]: 3.4 months). Patients treated with BsAb monotherapy achieved a median OS of 7.1 months. Multivariate analysis revealed that early relapse (<6 months), an Eastern Cooperative Oncology Group (ECOG) ≥ 2, and an elevated C-reactive protein (≥30 mg/L) were independently associ...