Page 159 - Haematologica Vol. 110 - January 2025

ARTICLE - R-GemOx+Atezo in R/R transformed DLBCL
phomas. Over the past few years, however, the Food and Drug Administration has approved newer agents such as CAR T-cell therapy and bispecific antibodies, which have all shown promising efficacy in transformed indolent lym- phomas.6,38-40 Since the study was conducted primarily in the era before these therapies were available, our study cohort included a small number of patients receiving CAR T cells and bispecific antibodies. Moreover, we note that four patients did not receive an anthracycline-contain- ing therapy for transformed DLBCL prior to enrollment, a standard-of-care treatment for this disease. The reasons for the treating investigators’ choice to forego a standard anthracycline-containing therapy for DLBCL were not col- lected during the trial.
With further validation, the R-GemOx-Atezo regimen could be considered as an option for patients who relapse after CAR T-cell and bispecific antibody therapy. There may be appeal from using a PD-1/PD-L1 blocking antibody after these immunotherapies as there may be augmentation or re-sensitization of the prior immunotherapy. Moreover, this regimen has potential use as a bridging regimen for those intended to receive CAR T cells, for patients with late relapses after initial chemoimmunotherapy with an indication for autologous HSCT, or for allogeneic HSCT. The immunogenic and/or chemosensitizing effects of R-GemOx and PD-1/PD-L1 blockade may possibly impact the efficacy of subsequent immunotherapies, such as CAR T cells or bispecific antibodies, as has previously been observed with PD-1/PD-L1 blockade.37
In conclusion, R-GemOx+Atezo was tolerable and effec- tive in transformed DLBCL. The highest response rate to R-GemOx+Atezo was in patients with transformed FL. The response rate in patients with RT was lower than what has been described in some prior studies employing check- point inhibitors. Our results support future evaluation of
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Disclosures
AFH has received research funding from and provided con- sultancy for ADC Therapeutics, AstraZeneca, Bristol Myers Squibb, Genentech, Merck, and Seattle Genetics; has received research funding from Gilead Sciences and KiTE Pharma; and has acted as a consultant for AbbVie, Adicet Bio, Allogene Therapeutics, Caribou Biosciences, Genmab, Karyopharm, Pfizer, Regeneron, Takeda, and Tubulis. The other authors have no conflicts of interest to disclose.
Contributions
TO and MV interpreted the analyses and wrote the manu- script. PF, NR, and CR conducted the statistical analyses. PA, LLP, GS, TS, AVD, and STR enrolled patients and edited the manuscript. SD, LP, and SK collected data and edited the manuscript. ES designed the study and edited the manu- script. JT designed the study, enrolled patients, and edited the manuscript. AFH designed the study, enrolled patients, interpreted the analyses, and wrote the manuscript.
Funding
AFH was supported by the Emmet and Toni Stephenson Leukemia and Lymphoma Society Scholar Award, and the Lymphoma Research Foundation Larry and Denise Mason Clinical Investigator Career Development Award. The research reported was supported by the National Cancer Institute of the National Institutes of Health under Award Number UM1CA186717.
Data-sharing statement
Original data and the protocol are available upon request. Please contact the corresponding author.
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