Glofitamab effectively bridging CD19-specific CAR T- cell therapy while maintaining safety in patients with refractory DLBCL

Abstract

Abstract Glofitamab, a bispecific antibody targeting CD20 and CD3, is approved for relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) after at least 2 prior treatment lines, but glofitamab bridging CAR T-cell therapy in real-world data are scarce. In this retrospective, we evaluated the outcomes of 10 patients with refractory DLBCL treated with glofitamab as bridging therapy to CAR T-cell therapy in Shanghai Tongji Hospital. In this cohort, TP53 mutation was present in 7 patients (70%). Six of 10 patients (60%) had double hit lymphoma and one patient had CNSL. Notably，all patients underwent leukapheresis prior to bridging treatment. The median follow-up time was 12 months. The median time of treatments with glofitamab was 1.5months, with 90% of patient response to their last treatment. After glofitmab infusion, cytokine release syndrome was observed in 60% of patients (all of them were grade 1), infections in 30% and no immune effector cell–associated neurotoxicity syndrome was observed. While, cytokine release syndrome was observed in 90% of patients (7of 10 patients were grade 1, 2/10 were grade 2), infections in 40% and immune effector cell–associated neurotoxicity syndrome in 20% for these patients after CAR T-cell infusion. The overall response rate was 80%, with 20% achieving complete responses (CR) and 60% partial responses after glofitamab infusion. Notably, 8 patients (80%) achieved CR at 3 months after CAR T-cell infusion. The median progression-free survival (PFS) was 6.5 months (95%CI，5.25-7.75), whereas the median overall survival was not achieved for patients. In summary, glofitamab birding CART therapy demonstrates promising efficacy and a manageable safety profile in refractory DLBCL in a real-world scenario.