Outcomes of patients aged ≥26 years with relapsed or refractory B-cell acute lymphoblastic leukemia in ZUMA-3 and historical trials

Leuk Lymphoma. 2024 Oct;65(10):1438-1447. doi: 10.1080/10428194.2024.2353877. Epub 2024 May 24.

Abstract

Brexucabtagene autoleucel (brexu-cel) is an autologous anti-CD19 CAR T-cell therapy approved in the USA and European Union (EU) for adults with relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL; aged ≥26 years in EU). Here, outcomes for patients with R/R B-ALL aged ≥26 years in ZUMA-3 treated with brexu-cel were compared with historical standard-of-care (SOC) therapy. After median follow-up of 26.8 months, the overall complete remission (CR) rate among patients treated with brexu-cel in Phase 2 (N = 43) was 72% and median overall survival (OS) was 25.4 months (95% CI, 15.9-NE). Median OS was improved in Phase 2 patients versus matched historical SOC-treated patients. Compared with aggregate historical trial data, Phase 1 and 2 patients had improved OS versus blinatumomab, inotuzumab, and chemotherapy in a matching-adjusted indirect comparison (MAIC) study. These data demonstrate clinical benefit of brexu-cel relative to SOC in patients ≥26 years with R/R B-ALL.

Keywords: B-cell acute lymphoblastic leukemia; CAR T-cell therapy; CD-19; SCHOLAR-3; ZUMA-3; brexucabtagene autoleucel.

MeSH terms

  • Adult
  • Aged
  • Antigens, CD19 / immunology
  • Antigens, CD19 / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Drug Resistance, Neoplasm
  • Female
  • Follow-Up Studies
  • Humans
  • Immunotherapy, Adoptive* / methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma* / mortality
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma* / therapy
  • Recurrence
  • Remission Induction / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Antigens, CD19