La thérapie cellulaire dans le lymphome folliculaire : où en sommes-nous en 2025?
Résumé
Les patients atteints d’un lymphome folliculaire (LF) à faible risque ont une survie globale (SG) médiane supérieure à 20 ans. En revanche, ceux qui présentent des caractéristiques défavorables, telles qu’un score élevé selon l’indice pronostique international du lymphome folliculaire (FLIPI) ou une progression de la maladie dans les 24 mois suivant le traitement de première intention (POD24), ont des résultats inférieurs. Le traitement standard en deuxième ligne et au-delà n’est pas clairement établi et dépend en grande partie de l’état de santé global du patient et de l’accès aux médicaments. La durée de la réponse diminue à chaque ligne de traitement. Dans cette revue, nous évaluerons les preuves relatives aux thérapies qui redirigent les lymphocytes T dans le LF.
Références
Casulo C, Byrtek M, Dawson KL, Zhou X, Farber CM, Flowers CR, et al. Early relapse of follicular lymphoma after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone defines patients at high risk for death: an analysis from the National LymphoCare Study. J Clin Oncol. 2015;33(23):2516–22.
Ghione P, Palomba ML, Ghesquieres H, Bobillo S, Patel AR, Nahas M, et al. Treatment patterns and outcomes in relapsed/refractory follicular lymphoma: results from the international SCHOLAR-5 study. Haematologica. 2022;108(3):822–32.
Jacobson CA, Chavez JC, Sehgal AR, William BM, Munoz J, Salles G, 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.
Neelapu SS, Chavez JC, Sehgal AR, Epperla N, Ulrickson M, Bachy E, et al. Three-year follow-up analysis of axicabtagene ciloleucel in relapsed/refractory indolent non-Hodgkin lymphoma (ZUMA-5). Blood. 2024;143(6):496–506.
Cordas dos Santos DM, Tix T, Shouval R, Gafter-Gvili A, Alberge JB, Cliff ERS, et al. A systematic review and meta-analysis of nonrelapse mortality after CAR T cell therapy. Nat Med. 2024;30(9):2667–78.
Fowler NH, Dickinson M, Dreyling M, Martinez-Lopez J, Kolstad A, Butler J, et al. Tisagenlecleucel in adult relapsed or refractory follicular lymphoma: the phase 2 ELARA trial. Nat Med. 2022;28(2):325–32.
Dreyling M, Fowler NH, Dickinson M, Martinez-Lopez J, Kolstad A, Butler J, et al. Durable response after tisagenlecleucel in adults with relapsed/refractory follicular lymphoma: ELARA trial update. Blood. 2024;143(17):1713–25.
Ghanem B. Efficacy, safety, and cost-minimization analysis of axicabtagene ciloleucel and tisagenlecleucel CAR T-Cell therapies for treatment of relapsed or refractory follicular lymphoma. Invest New Drugs. 2023;41(5):710–8.
Morschhauser F, Dahiya S, Palomba ML, Martin Garcia-Sancho A, Reguera Ortega JL, Kuruvilla J, et al. Lisocabtagene maraleucel in follicular lymphoma: the phase 2 TRANSCEND FL study. Nat Med. 2024;30(8):2199–207.
Budde LE, Sehn LH, Matasar M, Schuster SJ, Assouline S, Giri P, et al. Safety and efficacy of mosunetuzumab, a bispecific antibody, in patients with relapsed or refractory follicular lymphoma: a single-arm, multicentre, phase 2 study. Lancet Oncol. 2022;23(8):1055–65.
Sehn LH, Bartlett NL, Matasar MJ, Schuster SJ, Assouline SE, Giri P, et al. Long-term 3-year follow-up of mosunetuzumab in relapsed or refractory follicular lymphoma after ≥2 prior therapies. Blood. 2025;145(7):708–19.
Assouline S, Bartlett N, Matasar M, Schuster S, Sehn L, et al. Mosunetuzumab demonstrates clinically meaningful outcomes in high-risk patients with heavily pre-treated R/R FL after ≥3 years of follow-up: subgroup analysis of a pivotal phase II study. Abstract S233. In: presented at the European Hematology Association. 2024.
Matasar M, Rosettie KL, Mecke A, Di Maio D, Lin SW, Wu M, et al. Mosunetuzumab is Cost-Effective Compared with Alternative Novel Treatment Options in Patients with Third-Line or Later Relapsed/Refractory Follicular Lymphoma Over a Long-Term Horizon in the United States. Blood. 2024;144(Supplement 1):3648–3648.
Matasar M, Rosettie KL, Lin SW, Wu M, Ma E. lower total cost of care with mosunetuzumab compared with alternative novel treatment options in third-line or later relapsed/refractory follicular lymphoma: a United States third-party payer perspective. Blood. 2024;144(Supplement 1):5029–5029.
Linton KM, Vitolo U, Jurczak W, Lugtenburg PJ, Gyan E, Sureda A, et al. Epcoritamab monotherapy in patients with relapsed or refractory follicular lymphoma (EPCORE NHL-1): a phase 2 cohort of a single-arm, multicentre study. Lancet Haematol. 2024;11(8):e593–605.
Morschhauser F, Carlo-Stella C, Dickinson M, Phillips T, Houot R, Offner F, et al. Glofitamab as monotherapy and in combination with obinutuzumab induces high complete response rates in patients (pts) with multiple relapsed or refractory (R/R) follicular lymphoma (FL). Blood. 2021;138(Supplement 1):128–128.
Sesques P, Houot R, Al Tabaa Y, Le Bras F, Ysebaert L, Jardin F, et al. Glofitamab Monotherapy in patients with non-Hodgkin B-cell lymphoma after failing CAR T-cell infusion: primary analysis of the Bicar study, a phase II Lysa study. Blood. 2023;142(Supplement 1):893–893.
Crochet G, Iacoboni G, Couturier A, Bachy E, Iraola-Truchuelo J, Gastinne T, et al. Efficacy of CAR T-cell therapy is not impaired by previous bispecific antibody treatment in large B-cell lymphoma. Blood. 2024;144(3):334–8.
Kim J, Cho J, Lee MH, Yoon SE, Kim WS, Kim SJ. CAR T cells vs bispecific antibody as third- or later-line large B-cell lymphoma therapy: a meta-analysis. Blood. 2024 ;144(6):629–38.
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