For recurrent or refractory large B-cell lymphoma (LBCL), high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is regarded as the standard of care (SOC) second-line treatment. Results, however, continued to be inadequate. Therefore, as a second-line treatment for patients with LBCL that is resistant or relapsing within a year, researchers conducted a comprehensive review and meta-analysis of randomized controlled trials evaluating the effectiveness and safety of SOC to chimeric antigen receptor T-cell (CAR-T) therapy.

Safety, overall response rate (ORR), event-free survival (EFS), and overall survival (OS) were among the outcomes. About 85 individuals from three studies published in 2021 met the qualifying requirements. With CAR-T treatment, both EFS and OS considerably outperformed SOC, with hazard ratios (HR) of 0.57 (95% CI 0.49-0.68) and 0.77 (95% CI 0.60-0.98), respectively. In addition, the ORR for CAR-T treatment was considerably higher, with a relative risk (RR) of 1.55 (95% CI 1.12-2.13, P=0.001).

The two arms’ respective rates of Grade III/IV adverse events, RR 1.03 (95% CI 0.93-1.14), were comparable. In conclusion, CAR-T treatment, which is less toxic than SOC, offers better results for patients with LBCL that is resistant or relapsing within a year. However, to validate the findings and define the best CAR-T therapy sequencing for the treatment of LBCL, further, follow-up was required.

Reference: onlinelibrary.wiley.com/doi/10.1111/bjh.18335