TY - JOUR T1 - Association of bridging therapy utilization with clinical outcomes in patients receiving chimeric antigen receptor (CAR) T-cell therapy JF - Journal for ImmunoTherapy of Cancer JO - J Immunother Cancer DO - 10.1136/jitc-2022-004567 VL - 10 IS - 9 SP - e004567 AU - P Connor Johnson AU - Caron Jacobson AU - Alisha Yi AU - Mahmoud R Gaballa AU - Nora Horick AU - Dustin J Rabideau AU - Kevin Lindell AU - Gabriel D DePinho AU - Areej R El-Jawahri AU - Matthew J Frigault Y1 - 2022/09/01 UR - http://jitc.bmj.com/content/10/9/e004567.abstract N2 - Background Chimeric antigen receptor (CAR) T-cell therapy recipients may receive bridging therapy while awaiting product manufacturing to control disease. Yet, data are lacking regarding the impact of bridging therapy use on clinical outcomes.Methods We conducted a retrospective analysis of 235 patients who received CAR T-cell therapy at two tertiary care centers from February 2016 to December 2019. We abstracted clinical outcomes from review of the electronic health record including (1) overall response; (2) complete response (CR); (3) progression-free survival (PFS); (4) overall survival (OS); and (5) toxicity (cytokine release syndrome (CRS) and neurotoxicity). We assessed the association of bridging therapy use with overall response rate (ORR) and CR rate using multivariable logistic regression and with PFS and OS using multivariable Cox regression controlling for covariates. We analyzed the association of bridging therapy use with CRS and neurotoxicity using Fisher’s exact test.Results Patients’ median age was 63.1 years (range: 19–82), and the majority were men (144/235, 61.3%). Most patients received axicabtagene ciloleucel (192/235, 81.7%), and the most common lymphoma subtype was diffuse large B-cell lymphoma or grade 3B follicular lymphoma (107/235, 45.5%). Overall, 39.4% (93/236) received bridging therapy. Bridging therapy regimens included systemic chemotherapy (48/92, 52.2%), corticosteroids (25/92, 27.2%), radiation (9/92, 9.8%), and other systemic therapies (10/92, 10.9%). In multivariable Cox regression, bridging therapy use was associated with OS (HR: 1.97, p=0.004) but not PFS (HR: 1.18, p=0.449). In multivariable logistic regression, bridging therapy use was not associated with ORR (OR: 0.69, p=0.391) or CR rate (OR: 0.96, p=0.901). We did not identify an association of bridging therapy use with grade 3+ CRS (p=0.574) or grade 3+ neurotoxicity (p=0.748).Conclusions We identified that bridging therapy use is not associated with differences in ORR, CR rate, or PFS but is associated with worse OS. These data suggest bridging therapy may be a surrogate for additional poor prognostic factors leading to inferior OS and underscore the need for novel bridging therapy regimens to optimize outcomes in this patient population.Data are available upon reasonable request. ER -