• Prizlon-cel demonstrated a favorable safety profile with deep and durable response in patients with R/R B-NHL, especially in patients with LBCL.

  • Prizlon-cel could provide a promising treatment option for patients with R/R B-NHL.

Abstract

Prizloncabtagene autoleucel (prizlon-cel), a novel bispecific chimeric antigen receptor T cell, targets and eliminates CD19/CD20-positive tumor cells. This phase 1, open-label study investigated the safety and efficacy of prizlon-cel in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (R/R B-NHL). Patients with CD19 and/or CD20-positive R/R B-NHL received a 3-day lymphodepletion (cyclophosphamide: 300 mg/m2 per day; fludarabine: 30 mg/m2 per day) followed by an IV dose of prizlon-cel. The primary end points were dose-limiting toxicity (DLT) and incidence and severity of treatment-emergent adverse events (TEAEs). Secondary end points included overall response rate (ORR), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Of the 48 patients infused prizlon-cel, 44 had large B-cell lymphoma (LBCL). No patient experienced DLT. Cytokine release syndrome occurred in 93.8% of the patients, with only 1 case of grade 3. Immune effector cell-associated neurotoxicity syndrome occurred in 6.3% of patients, with no grade 3 or higher events. The most common grade 3 or higher TEAEs were neutropenia (83.3%) and leukopenia (50%). The ORR and complete response (CR) rates in all patients were 91.5% and 85.1%, respectively, and in LBCL patients, ORR was 90.7% with 86.0% CR. With median follow-up of 30.0 months, median DOR, PFS, and OS were all not reached. Kaplan-Meier estimate of 2-year DOR, PFS, and OS rates were 66.0%, 62.6%, and 76.5%, respectively. Prizlon-cel had a favorable safety profile and a high and durable response in patients with R/R B-NHL, suggesting a promising treatment option for patients with R/R B-NHL. These trials were registered at www.clinicaltrials.gov as #NCT04317885, #NCT04655677, #NCT04696432, and #NCT04693676.

1.
Neelapu
SS
,
Locke
FL
,
Bartlett
NL
, et al
.
Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma
.
N Engl J Med
.
2017
;
377
(
26
):
2531
-
2544
.
2.
Abramson
JS
,
Palomba
ML
,
Gordon
LI
, et al
.
Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study
.
Lancet
.
2020
;
396
(
10254
):
839
-
852
.
3.
Schuster
SJ
,
Bishop
MR
,
Tam
CS
, et al
.
Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma
.
N Engl J Med
.
2019
;
380
(
1
):
45
-
56
.
4.
Jacobson
CA
,
Chavez
JC
,
Sehgal
AR
, et al
.
Axicabtagene ciloleucel in relapsed or refractory indolent non-Hodgkin lymphoma (ZUMA-5): a single-arm, multicentre, phase 2 trial
.
Lancet Oncol
.
2022
;
23
(
1
):
91
-
103
.
5.
Wang
M
,
Munoz
J
,
Goy
A
, et al
.
KTE-X19 CAR T-cell therapy in relapsed or refractory mantle-cell lymphoma
.
N Engl J Med
.
2020
;
382
(
14
):
1331
-
1342
.
6.
Fowler
NH
,
Dickinson
M
,
Dreyling
M
, et al
.
Tisagenlecleucel in adult relapsed or refractory follicular lymphoma: the phase 2 ELARA trial
.
Nat Med
.
2022
;
28
(
2
):
325
-
332
.
7.
Ying
Z
,
Yang
H
,
Guo
Y
, et al
.
Relmacabtagene autoleucel (relma-cel) CD19 CAR-T therapy for adults with heavily pretreated relapsed/refractory large B-cell lymphoma in China
.
Cancer Med
.
2021
;
10
(
3
):
999
-
1011
.
8.
Plaks
V
,
Rossi
JM
,
Chou
J
, et al
.
CD19 target evasion as a mechanism of relapse in large B-cell lymphoma treated with axicabtagene ciloleucel
.
Blood
.
2021
;
138
(
12
):
1081
-
1085
.
9.
Locke
FL
,
Filosto
S
,
Chou
J
, et al
.
Impact of tumor microenvironment on efficacy of anti-CD19 CAR T cell therapy or chemotherapy and transplant in large B cell lymphoma
.
Nat Med
.
2024
;
30
(
2
):
507
-
518
.
10.
Ruella
M
,
Korell
F
,
Porazzi
P
,
Maus
MV
.
Mechanisms of resistance to chimeric antigen receptor-T cells in haematological malignancies
.
Nat Rev Drug Discov
.
2023
;
22
(
12
):
976
-
995
.
11.
Rasheed
AA
,
Samad
A
,
Raheem
A
,
Hirani
SI
,
Shabbir- Moosajee
M
.
CD20 expression and effects on outcome of relapsed/ refractory diffuse large B cell lymphoma after rreatment with rituximab
.
Asian Pac J Cancer Prev
.
2018
;
19
(
2
):
331
-
335
.
12.
Michot
JM
,
Buet-Elfassy
A
,
Annereau
M
, et al
.
Clinical significance of the loss of CD20 antigen on tumor cells in patients with relapsed or refractory follicular lymphoma
.
Cancer Drug Resist
.
2021
;
4
(
3
):
710
-
718
.
13.
Maeshima
AM
,
Taniguchi
H
,
Fujino
T
, et al
.
Immunohistochemical CD20-negative change in B-cell non-Hodgkin lymphomas after rituximab-containing therapy
.
Ann Hematol
.
2020
;
99
(
9
):
2141
-
2148
.
14.
Maeshima
AM
,
Taniguchi
H
,
Fukuhara
S
, et al
.
Follow-up data of 10 patients with B-cell non-Hodgkin lymphoma with a CD20-negative phenotypic change after rituximab-containing therapy
.
Am J Surg Pathol
.
2013
;
37
(
4
):
563
-
570
.
15.
Maeshima
AM
,
Taniguchi
H
,
Nomoto
J
, et al
.
Histological and immunophenotypic changes in 59 cases of B-cell non-Hodgkin’s lymphoma after rituximab therapy
.
Cancer Sci
.
2009
;
100
(
1
):
54
-
61
.
16.
Zhang
Y
,
Wang
Y
,
Liu
Y
, et al
.
Long-term activity of tandem CD19/CD20 CAR therapy in refractory/relapsed B-cell lymphoma: a single-arm, phase 1-2 trial
.
Leukemia
.
2022
;
36
(
1
):
189
-
196
.
17.
Zurko
JC
,
Fenske
TS
,
Johnson
BD
, et al
.
Long-term outcomes and predictors of early response, late relapse, and survival for patients treated with bispecific LV20.19 CAR T-cells
.
Am J Hematol
.
2022
;
97
(
12
):
1580
-
1588
.
18.
Tong
C
,
Zhang
Y
,
Liu
Y
, et al
.
Optimized tandem CD19/CD20 CAR-engineered T cells in refractory/relapsed B-cell lymphoma
.
Blood
.
2020
;
136
(
14
):
1632
-
1644
.
19.
Liang
A
,
Zhou
L
,
Li
P
, et al
.
Safety and efficacy of a novel anti-CD20/CD19 bi-specific CAR T-cell therapy (C-CAR039) in relapsed or refractory (r/r) B-cell non-Hodgkin lymphoma (B-NHL) [abstract]
.
J Clin Oncol
.
2021
;
39
(
suppl 15
):
2507
.
20.
Neelapu
SS
,
Jacobson
CA
,
Ghobadi
A
, et al
.
Five-year follow-up of ZUMA-1 supports the curative potential of axicabtagene ciloleucel in refractory large B-cell lymphoma
.
Blood
.
2023
;
141
(
19
):
2307
-
2315
.
21.
Schuster
SJ
,
Tam
CS
,
Borchmann
P
, et al
.
Long-term clinical outcomes of tisagenlecleucel in patients with relapsed or refractory aggressive B-cell lymphomas (JULIET): a multicentre, open-label, single-arm, phase 2 study
.
Lancet Oncol
.
2021
;
22
(
10
):
1403
-
1415
.
22.
Ying
Z
,
Yang
H
,
Guo
Y
, et al
.
Long-term outcomes of relmacabtagene autoleucel in Chinese patients with relapsed/refractory large B-cell lymphoma: Updated results of the RELIANCE study
.
Cytotherapy
.
2023
;
25
(
5
):
521
-
529
.
23.
Locke
FL
,
Ghobadi
A
,
Jacobson
CA
, et al
.
Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1-2 trial
.
Lancet Oncol
.
2019
;
20
(
1
):
31
-
42
.
24.
Abramson
JS
,
Palomba
ML
,
Gordon
LI
, et al
.
Two-year follow-up of lisocabtagene maraleucel in relapsed or refractory large B-cell lymphoma in TRANSCEND NHL 001
.
Blood
.
2024
;
143
(
5
):
404
-
416
.
25.
Thieblemont
C
,
Phillips
T
,
Ghesquieres
H
, et al
.
Epcoritamab, a novel, subcutaneous CD3xCD20 bispecific T-cell-engaging antibody, in relapsed or refractory large B-cell lymphoma: dose expansion in a phase I/II trial
.
J Clin Oncol
.
2023
;
41
(
12
):
2238
-
2247
.
26.
Dickinson
MJ
,
Carlo-Stella
C
,
Morschhauser
F
, et al
.
Glofitamab for relapsed or refractory diffuse large B-cell lymphoma
.
N Engl J Med
.
2022
;
387
(
24
):
2220
-
2231
.
27.
Caimi
PF
,
Ai
W
,
Alderuccio
JP
, et al
.
Loncastuximab tesirine in relapsed or refractory diffuse large B-cell lymphoma (LOTIS-2): a multicentre, open-label, single-arm, phase 2 trial
.
Lancet Oncol
.
2021
;
22
(
6
):
790
-
800
.
28.
Sehn
LH
,
Herrera
AF
,
Flowers
CR
, et al
.
Polatuzumab vedotin in relapsed or refractory diffuse large B-cell lymphoma
.
J Clin Oncol
.
2020
;
38
(
2
):
155
-
165
.
29.
Kalakonda
N
,
Maerevoet
M
,
Cavallo
F
, et al
.
Selinexor in patients with relapsed or refractory diffuse large B-cell lymphoma (SADAL): a single-arm, multinational, multicentre, open-label, phase 2 trial
.
Lancet Haematol
.
2020
;
7
(
7
):
e511
-
e522
.
30.
Liu
H
,
Li
P
,
Zhao
A
,
Lei
W
,
Liang
A
,
Qian
W
.
Incidence and prophylaxis of herpes zoster in relapsed or refractory B-cell lymphoma patients after CD19-specific CAR-T cell therapy
.
Leuk Lymphoma
.
2022
;
63
(
4
):
1001
-
1004
.
31.
Damotte
D
,
Le Tourneau
A
,
Audouin
J
, et al
.
Discordant malignant lymphoma synchronous or successive high-grade B lymphoma associated with Hodgkin's disease. A clinico pathologic and immunophenotypic study of 4 cases
.
Pathol Res Pract
.
1995
;
191
(
1
):
8
-
15
.
32.
Niino
D
,
My Hanh
LT
,
Miura
S
,
Nakashima
M
,
Iwanaga
M
.
Incidence patterns of sequential or composite lymphoma: a population-based cancer registry study
.
Tohoku J Exp Med
.
2021
;
254
(
2
):
123
-
127
.
33.
Opsahl
MP
,
Hammer
RD
,
Laziuk
K
.
Synchronous discordant Epstein-Barr virus (EBV)–positive nodal T/NK-cell lymphoma and EBV-positive diffuse large B cell lymphoma in a patient with a history of EBV-positive Burkitt lymphoma
.
J Hematopathol
.
2018
;
11
(
4
):
119
-
125
.
34.
Abruzzo
LV
,
Griffith
LM
,
Nandedkar
M
, et al
.
Histologically discordant lymphomas with B-cell and T-cell components
.
Am J Clin Pathol
.
1997
;
108
(
3
):
316
-
323
.
35.
Ghilardi
G
,
Fraietta
JA
,
Gerson
JN
, et al
.
T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy
.
Nat Med
.
2024
;
30
(
4
):
984
-
989
.
36.
Harrison
SJ
,
Nguyen
T
,
Rahman
M
, et al
.
CAR+ T-cell lymphoma post ciltacabtagene autoleucel therapy for relapsed refractory multiple myeloma [abstract]
.
Blood
.
2023
;
142
(
suppl 1
):
6939
.
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