Explore the BREYANZI data from the TRANSFORM trial1
SOC consisted of salvage immunochemotherapy followed by HDCT and autologous HSCT.1
Jump to section:
Adapted from the BREYANZI Product Monograph
The median EFS was NR in the BREYANZI arm after a median follow-up of 17.53 months vs. the SOC arm where the median EFS was 2.4 months after a medium follow-up of 17.49 months (HR=0.356 [95% CI: 0.243-0.522]).
Overall survival (OS; secondary endpoint) data
Median OS was NR in the BREYANZI arm vs. 29.9 months in the SOC arm (HR=0.724 [95% CI:
0.443-1.183]) based on the interim analysis performed at the median follow-up of 17.53 months and 17.49 months, for BREYANZI and SOC, respectively.
3L: third-line; CI: confidence interval; CR: complete response; CRR: complete response rate; HDCT: high-dose chemotherapy; HSCT: hemopoietic stem cell transplant; HR: hazard ratio; NR: not reached; PFS: progression-free survival; PR: partial response; SOC: standard of care.
* TRANSFORM was a Phase 3 open-label, randomized, parallel-group, multicentre trial in adult patients with LBCL primary refractory to or relapsed within 12 months from a complete response to initial chemoimmunotherapy, who were candidates for autologous hemopoietic stem cell transplant. 92 patients underwent leukapheresis and 89 patients received a single intravenous infusion of BREYANZI.
† Per the Lugano criteria, as assessed by independent review committee, and based on primary evidence and analysis for the hypothesis testing purpose (cutoff date: 08 Mar 2021).
‡ EFS was defined as the time from randomization to death from any cause, progressive disease, failure to achieve CR or PR by 9 weeks post-randomization (after 3 cycles of salvage chemotherapy and 5 weeks after BREYANZI infusion) or start of new antineoplastic therapy due to efficacy concerns, whichever occurs first.
§ Based on a stratified Cox proportional hazards model.
¶ P-value is compared with 0.012 of the allocated alpha.
STUDY DETAILS
TRANSFORM trial design1,2
Randomized, open-label, multicentre, parallel-group
Patient population
Adult patients with
R/R large B-cell lymphoma
92 patients
underwent leukapheresis
89 patients
received BREYANZI
Select baseline patient demographics
BREYANZI
SOC
Age range (yrs)
20–74
26–75
<65 ans
61%
73%
Refractory*
73% (67/92)
70% (76/92)
Relapsed†
27% (25/92)
24% (22/92)
Dosing
Single intravenous infusion of BREYANZI
- Dose range of 97–103 x 106 CAR+ viable T cells (consisting of CD8 and CD4 components at a ratio range from 0.8 to 1.2)
or
SOC
- Salvage immunochemotherapy followed by HDCT and autologous HSCT
Primary endpoint:
Event-free survival (EFS)‡
Secondary endpoint:
Complete response rate (CRR), progression-free survival (PFS), overall survival (OS)
BREYANZI was administered in the inpatient (79%) or outpatient (21%) setting.1
BREYANZI TRANSFORM trial inclusion and exclusion criteria1
Inclusion criteria
The study included:
- Adult patients with large B-cell non-Hodgkin lymphoma primary refractory to or relapsed within 12 months from a complete response to initial chemoimmunotherapy, who were candidates for autologous HSCT
- Patients with DLBCL NOS, de novo or transformed indolent NHL, HGBCL with MYC and BCL2 and/or BCL6 rearrangements with DLBCL histology (double/triple hit lymphoma), PMBCL, THRBCL, FL3B
- Patients with ECOG performance status ≤1
- Secondary central nervous system lymphoma involvement
Exclusion criteria
The study excluded patients with:
- A creatinine clearance of <45 mL/min
- Alanine aminotransferase >5 times the upper limit of normal Left ventricular ejection fraction <40%
- Left ventricular ejection fraction <40%
- Absolute neutrophil count <1.0 x 109 cells/L
- Platelets <50 x 109 cells/L in the absence of bone marrow involvement
The inclusion and exclusion criteria were chosen to ensure adequate organ function, and blood counts for HSCT
CAR: chimeric antigen receptor; CR: complete response; DLBCL: diffuse large B-cell lymphoma; ECOG: Eastern Cooperative Oncology Group; FL3B: follicular lymphoma Grade 3B; HDCT: high-dose chemotherapy; HGBCL: high-grade B-cell lymphoma; HSCT: hemopoietic stem cell transplant; NHL: non-Hodgkin lymphoma; NOS: not otherwise specified; PMBCL: primary mediastinal large B-cell lymphoma; PR: partial response; R/R: relapsed or refractory; SOC: standard of care; THRBCL: T cell/histiocyte-rich large B-cell lymphoma.
* Defined as stable disease, progressive disease, PR, or CR with relapse <3 months after first-line therapy.
† Defined as CR with relapse on or after 3 months within 12 months after first-line therapy.
‡ EFS was defined as the time from randomization to death from any cause, progressive disease, failure to achieve CR or PR by 9 weeks post-randomization (after 3 cycles of salvage chemotherapy and 5 weeks after BREYANZI infusion) or start of new antineoplastic therapy due to efficacy concerns, whichever occurs first.
Adapted from the BREYANZI Product Monograph
CI: confidence interval; SOC: standard of care.
* Per the Lugano criteria, as assessed by independent review committee and based on the analysis with cutoff date of 13 May 2022.
† P-value is compared with 0.021 of the allocated alpha.
‡ Cochran-Mantel-Haenszel test.
Median PFS:
BREYANZI NR (95% CI: 12.6-NR), SOC arm 6.2 months (95% CI: 4.3-8.6)
Adapted from Abramson et al. 20232
CI: confidence interval; HR: hazard ratio; NR: not reached.
* Per the Lugano criteria, as assessed by independent review committee and based on the analysis with cutoff date of 13 May 2022.
† Based on a stratified Cox proportional hazards model.
‡ P-value is compared with 0.021 of the allocated alpha.
3L: third-line.
References:
1. BREYANZI Product Monograph. Bristol-Myers Squibb Company.
2. Abramson JS, et al. Lisocabtagene maraleucel as second-line therapy for large B-cell lymphoma: primary analysis of the phase 3 TRANSFORM study. Blood. 2023;141(14):1675-1684.