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KTE-X19 for relapsed or refractory adult B-cell acute lymphoblastic leukaemia: phase 2 results of the single-arm, open-label, multicentre ZUMA-3 study

Open access
Shah, Bijal D, Ghobadi, Armin, Oluwole, Olalekan O, Logan, Aaron C, Boissel, Nicolas, Cassaday, Ryan D, Leguay, Thibaut, Bishop, Michael R, Topp, Max S, Tzachanis, Dimitrios, O'Dwyer, Kristen M, Arellano, Martha L, Lin, Yi, Baer, Maria R, Schiller, Gary J, Park, Jae H, Subklewe, Marion, Abedi, Mehrdad, Minnema, Monique C, Wierda, William G, DeAngelo, Daniel J, Stiff, Patrick, Jeyakumar, Deepa, Feng, Chaoling, Dong, Jinghui, Shen, Tong, Milletti, Francesca, Rossi, John M, Vezan, Remus, Masouleh, Behzad Kharabi, Houot, Roch·2021·The Lancet

Abstract

Background: We report the pivotal phase 2 results of ZUMA-3, an international, multicenter study evaluating the efficacy and safety of the autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy KTE-X19 in adult patients with relapsed/refractory B-precursor acute lymphoblastic leukemia (B-ALL). Methods: Adults with relapsed/refractory B-ALL were enrolled. After leukapheresis and conditioning chemotherapy, patients received a single KTE-X19 infusion (1×106 CAR T cells/kg). The primary endpoint was the overall complete remission (CR)/CR with incomplete hematologic recovery (CRi) rate by central assessment. ZUMA-3 is registered with ClinicalTrials.gov (NCT02614066). Findings: Among 71 enrolled patients, KTE-X19 was successfully manufactured for 65 and administered to 55. The median age among treated patients was 40 years (IQR, 28–52). At the median follow-up of 16·4 months, 39 patients (70·9% [95% CI, 57–82; p<0·0001]) achieved CR/CRi, with 31 patients (56·4%) achieving CR. The medians for duration of remission, relapse-free survival, and overall survival were 12·8, 11·6, and 18·2 months, respectively. Among patients with CR/CRi, the median overall survival was not reached, and 38 patients (97%) achieved minimal residual disease negativity. Ten patients (18%) received allogeneic stem-cell transplant consolidation post–KTE-X19 infusion. The most common grade ≥3 adverse events were anemia (27 patients [49%]) and pyrexia (20 patients [36%]). Fourteen patients (25%) had grade ≥3 infections. Two grade 5 KTE-X19–related events (brain herniation; septic shock) occurred. Grade ≥3 cytokine release syndrome and neurologic events occurred in 13 (24%) and 14 patients (25%), respectively. Patient-reported outcomes indicated that most evaluable patients experienced improved or stable quality of life. Interpretation: KTE-X19 demonstrated a high CR/CRi rate in relapsed/refractory B-ALL, with the median overall survival not reached in responding patients, and a manageable safety profile. These findings indicate that KTE-X19 has the potential to confer long-term clinical benefit to adult patients with relapsed/refractory B-ALL. Funding: Kite, a Gilead company.

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Metadata

Authors
Shah, B. D., Ghobadi, A., Oluwole, O. O., Logan, A. C., Boissel, N., Cassaday, R. D., Leguay, T., Bishop, M. R., Topp, M. S., Tzachanis, D., O'Dwyer, K. M., Arellano, M. L., Lin, Y., Baer, M. R., Schiller, G. J., Park, J. H., Subklewe, M., Abedi, M., Minnema, M. C., Wierda, W. G., DeAngelo, D. J., Stiff, P., Jeyakumar, D., Feng, C., Dong, J., Shen, T., Milletti, F., Rossi, J. M., Vezan, R., Masouleh, B. K., & Houot, R.
Venue
The Lancet
Publisher
Elsevier BV
Published
2021-08
Volume
398
Issue
10299
Pages
491-502
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W3169193862
Cited by
820
References
28
FWCI
42.23
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: KTE-X19 for relapsed or refractory adult B-cell acute lymphoblastic leukaemia: phase 2 results of the single-arm, open-label, multicentre ZUMA-3 study. https://app.cochat.ai/papers/10.1016/s0140-6736(21)01222-8
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Shah, B. D., Ghobadi, A., Oluwole, O. O., Logan, A. C., Boissel, N., Cassaday, R. D., Leguay, T., Bishop, M. R., Topp, M. S., Tzachanis, D., O'Dwyer, K. M., Arellano, M. L., Lin, Y., Baer, M. R., Schiller, G. J., Park, J. H., Subklewe, M., Abedi, M., Minnema, M. C., . . . Houot, R. (2021). KTE-X19 for relapsed or refractory adult B-cell acute lymphoblastic leukaemia: phase 2 results of the single-arm, open-label, multicentre ZUMA-3 study. The Lancet. https://doi.org/10.1016/s0140-6736(21)01222-8

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.