本研究对51例大B细胞淋巴瘤复发/难治患者，采用回顾性评估法评价了萨维治疗的结果，这些患者之前接受了阿芙西卡布吡单抗与替噻可利单抗治疗。其中，22例（43％）参加了临床试验（glofitamab或loncastuximab tesirine+ibrutinib），而29例接受了标准治疗（来那度胺[Len]、检查点抑制剂[CPI]、伊布替尼[I]、化疗免疫疗法和放疗）或支持性护理。总体而言，39例（67％）接受治疗的患者中，有26例采用了以免疫疗法（glofitamab、CPI、Len）为基础的治疗，其中以双特异性抗体（n = 18）为主。在这个亚组中，收集了血浆样本，并利用癌症个性化深度测序（CAPP-seq）法对循环肿瘤DNA（ctDNA）进行了分析。研究发现，ctDNA含量高的患者预后较差。在中位随访时间为11.7个月的情况下，预计的12个月总生存率（OS）为35％。在多因素模型中，对预后不利的因素是CAR T细胞治疗无反应（HR：3.08；p = 0.0109）以及非原发性转变性大B细胞淋巴瘤和tFL诊断（HR：4.54；p = 0.0069）。CAR T细胞治疗失败的患者预后不佳，需要进一步研究。©2023 The Authors. British Journal of Haematology，由British Society for Haematology和John Wiley＆Sons Ltd.出版。

This study retrospectively evaluated the outcome of salvage therapy in 51 patients who failed axicabtagene ciloleucel or tisagenlecleucel for relapsed/refractory large B-cell lymphomas. Of these patients, 22 (43%) were enrolled in clinical trials (glofitamab or loncastuximab tesirine + ibrutinib), whereas 29 received standard therapies (lenalidomide [Len], checkpoint inhibitors [CPIs], ibrutinib [I], chemoimmunotherapy and radiotherapy) or supportive care. Overall, 26 of 39 (67%) treated patients received a treatment based on immunotherapy (glofitamab, CPI, Len) that was mainly represented by bispecific antibody (n = 18). In this subgroup, plasma samples were collected and analysed for circulating tumour DNA (ctDNA) using cancer-personalized profiling by deep sequencing (CAPP-seq). The study found that patients with high ctDNA had poor outcomes. At a median follow-up of 11.7 months, the estimated 12-month overall survival (OS) was 35%. Factors adversely affecting the prognosis in the multivariable model were the absence of response to CAR T-cell therapy (HR: 3.08; p = 0.0109) and a diagnosis other than PMBCL and t-FL (HR: 4.54; p = 0.0069). The outcome of patients failing CAR T cells is poor and requires further investigation.© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.