Higher Rates of Response, Toxicity with Axicabtagene Ciloleucel Than Tisagenlecleucel in DLBCL

Axicabtagene ciloleucel led to higher response rates and higher toxicity rates than tisagenlecleucel in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), according to a recent study.

Emmanuel Bachy, MD, PhD, of the Hospices Civils de Lyon, and colleagues conducted the study and published its results in Nature Medicine.

They retrospectively analyzed outcomes of 809 patients with relapsed/refractory DLBCL who received axicabtagene ciloleucel or tisagenlecleucel after two or more previous lines of therapy. Dr. Bachy and colleagues collected the data from the French DESCAR-T registry and performed 1:1 propensity score matching (n=418).

The best overall response rate was 80% in patients who received axicabtagene ciloleucel, while it was 66% for those who received tisagenlecleucel (P<.001) The complete response rate was also significantly higher (60%) in those who received axicabtagene ciloleucel than in those who received tisagenlecleucel (42%; P<.001).

The one-year progression-free survival rate was 46.6% in patients receiving axicabtagene ciloleucel but was significantly lower in patients who received tisagenlecleucel (33.2%; hazard ratio (HR), 0.61; 95% CI, 0.46-0.79; P=.0003). The one-year overall survival rate was significantly higher in patients who received axicabtagene ciloleucel (63.5%) than those receiving tisagenlecleucel (48.8%; HR, 0.63; 95% CI, 0.45-0.88; P=.0072).

Patients who received axicabtagene ciloleucel had a significantly higher frequency of grade 1 or grade 2 cytokine release syndrome than those who received tisagenlecleucel, although there was no significant difference between the treatments in the frequency of grade 3 or higher cytokine release syndrome. Patients who received axicabtagene ciloleucel also had significantly higher rates of immune effector cell-associated neurotoxicity syndrome of any grade than those who received tisagenlecleucel.

“Our matched comparison study supports a higher efficacy and also a higher toxicity of [axicabtagene ciloleucel] compared to [tisagenlecleucel] in the third or more treatment line for [relapsed/refractory] DLBCL,” Dr. Bachy and colleagues concluded.

Reference

Bachy E, Le Gouill S, Di Blasi R, et al. A real-world comparison of tisagenlecleucel and axicabtagene ciloleucel CAR T cells in relapsed or refractory diffuse large B cell lymphoma. Nat Med. 2022;28(10):2145-2154. doi:10.1038/s41591-022-01969-y