Different treatment eras for relapsed and refractory primary mediastinal B-cell lymphoma patients: accessibility to CAR T cells is associated with a better prognosis in a pooled analysis of the REPRIME-FIL and the CART-SIE studies

Chimeric Antigen Receptor (CAR) T-cell therapy targeting CD19 has demonstrated efficacy as salvage treatment for patients with relapsed/refractory (R/R) primary mediastinal B-cell lymphoma (PMBCL), however, a direct comparison between CAR T activity and other salvage treatments has not previously been performed. This study aims to compare overall survival (OS) in R/R PMBCL patients treated in different eras who reflect accessibility to CAR T-cells in R/R patient treated after 2019 and treatment with other salvage programs in the years before. We performed a pooled analysis including all pts affected by R/R PMBCL enrolled in the ongoing multicenter prospective observational study CART-SIE and in the retrospective REPRIME-FIL study. A total of 191 patients were included, 87 receiving CAR T cells and 104 treated with other salvage therapies. The 3-year OS from failure of first line treatment for the entire cohort was 62% (95% CI 55-69). The 6-months landmark analysis showed that patients treated with CAR T cells had a significantly reduced risk of death and a superior OS compared with those receiving other regimens (adjusted HR 0.34; 95%CI 0.17-0.66, p=0.001). Patients treated with CAR T cells also had superior OS compared with the subgroup of REPRIME patients who underwent ASCT (adjusted HR 0.27; 95%CI 0.13-0.66, p=0.001). Within the limitations inherent to a pooled analysis, administration of CAR T cells during salvage of R/R PMBCL patients appears to be associated with a longer OS with a risk of death approximately one-third of that observed in patients managed without CAR T.

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Publication Details

Journal
Haematologica
Published
2026-09-24
DOI
https://doi.org/10.3324/haematol.2026.300977
Primary Topic
CAR-T cell therapy research
Type
article
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article

Different treatment eras for relapsed and refractory primary mediastinal B-cell lymphoma patients: accessibility to CAR T cells is associated with a better prognosis in a pooled analysis of the REPRIME-FIL and the CART-SIE studies

Emilio Iannitto, Monica Balzarotti, Mauro Krampera, Andrea Evangelista et al.
Haematologica
CAR-T cell therapy research
article

Different treatment eras for relapsed and refractory primary mediastinal B-cell lymphoma patients: accessibility to CAR T cells is associated with a better prognosis in a pooled analysis of the REPRIME-FIL and the CART-SIE studies

Emilio Iannitto, Monica Balzarotti, Mauro Krampera, Andrea Evangelista, Giovanni Grillo, Patrizia Chiusolo, Stéfania Bramanti, Annalisa Chiappella, Alice Di Rocco, Emanuele Ravano, Giulia Zacchi, Anna Guidetti, Beatrice Casadei, Martelli Maurizio, Maurizio Musso, Massimo Martino, Anna Dodero, Pier Luigi Zinzani, Federica Cavallo, Irene Dogliotti, Paolo Corradini, Stefan Hohaus, Carlo Visco, Mirko Farina, Alessandro Re, Ugo Consoli, Manuela Zanni
article en

Abstract

Chimeric Antigen Receptor (CAR) T-cell therapy targeting CD19 has demonstrated efficacy as salvage treatment for patients with relapsed/refractory (R/R) primary mediastinal B-cell lymphoma (PMBCL), however, a direct comparison between CAR T activity and other salvage treatments has not previously been performed. This study aims to compare overall survival (OS) in R/R PMBCL patients treated in different eras who reflect accessibility to CAR T-cells in R/R patient treated after 2019 and treatment with other salvage programs in the years before. We performed a pooled analysis including all pts affected by R/R PMBCL enrolled in the ongoing multicenter prospective observational study CART-SIE and in the retrospective REPRIME-FIL study. A total of 191 patients were included, 87 receiving CAR T cells and 104 treated with other salvage therapies. The 3-year OS from failure of first line treatment for the entire cohort was 62% (95% CI 55-69). The 6-months landmark analysis showed that patients treated with CAR T cells had a significantly reduced risk of death and a superior OS compared with those receiving other regimens (adjusted HR 0.34; 95%CI 0.17-0.66, p=0.001). Patients treated with CAR T cells also had superior OS compared with the subgroup of REPRIME patients who underwent ASCT (adjusted HR 0.27; 95%CI 0.13-0.66, p=0.001). Within the limitations inherent to a pooled analysis, administration of CAR T cells during salvage of R/R PMBCL patients appears to be associated with a longer OS with a risk of death approximately one-third of that observed in patients managed without CAR T.

Haematologica
Università Cattolica del Sacro Cuore (IT), University of Verona (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Azienda ospedaliera "Bianchi-Melacrino-Morelli" (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Ospedale Garibaldi (IT), Istituto di Ematologia di Bologna (IT), Azienda USL di Bologna (IT), Fondazione IRCCS Istituto Nazionale dei Tumori (IT), Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo (IT), IRCCS Humanitas Research Hospital (IT), La Maddalena (IT), Sapienza University of Rome (IT), University of Bologna (IT)
Good health and well-being
Openalex Percentile: Top 14%
CAR-T cell therapy research
DOIOpen Access PDFOpenAlex
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