tisagenlecleucel 与 axicabtagene ciloleucel CAR-T 细胞治疗复发/难治性弥漫大 B 细胞淋巴瘤的真实世界比较

Axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) have both demonstrated impressive clinical activity in relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL). In this study, we analyzed the outcome of 809 patients with R/R DLBCL after two or more previous lines of treatment who had a commercial chimeric antigen receptor (CAR) T cells order for axi-cel or tisa-cel and were registered in the retrospective French DESCAR-T registry study ( NCT04328298 ).

After 1:1 propensity score matching (n = 418), the best overall response rate/complete response rate (ORR/CRR) was 80%/60% versus 66%/42% for patients treated with axi-cel compared to tisa-cel, respectively (P < 0. 001 for both ORR and CRR comparisons). After a median follow-up of 11. 7 months, the 1-year progression-free survival was 46. 6% for axi-cel and 33. 2% for tisa-cel (hazard ratio (HR) = 0. 61; 95% confidence interval (CI), 0. 46-0. 79; P = 0. 0003).

Overall survival (OS) was also significantly improved after axi-cel infusion compared to after tisa-cel infusion (1-year OS 63. 5% versus 48. 8%; HR = 0. 63; 95% CI, 0. 45-0. 88; P = 0. 0072). Similar findings were observed using the inverse probability of treatment weighting statistical approach.

Grade 1-2 cytokine release syndrome was significantly more frequent with axi-cel than with tisa-cel, but no significant difference was observed for grade 3. Regarding immune effector cell-associated neurotoxicity syndrome (ICANS), both grade 1-2 and grade 3 ICANS were significantly more frequent with axi-cel than with tisa-cel.

In conclusion, our matched comparison study supports a higher efficacy and also a higher toxicity of axi-cel compared to tisa-cel in the third or more treatment line for R/R DLBCL.