基于荟萃分析的 Axi-Cel 与 Tisa-Cel 疗效与安全性比较

This study aimed to analyze the efficacy and safety of chimeric antigen receptor T-cell (CAR-T) therapy for B-cell lymphoma using published literature data. Literature on CAR-T therapy for B-cell lymphoma was collected by searching common databases. The literature was screened, quality assessed, and data extracted according to the inclusion and exclusion criteria.

We performed a quantitative meta-analysis of the efficacy and safety of combined literature data. If the data could not be combined, descriptive analysis was performed. The meta-analysis results indicated that compared with tisagenlecleucel (tisa-cel), axicabtagene ciloleucel (axi-cel) had higher objective response rate (ORR) and complete response rate, with odds ratio (OR) of 0. 63 for both sides (95% confidence interval [CI], 0. 50-0. 79) and statistically significant differences. Partial response rate was lower with axi-cel than with tisa-cel, with an OR of 1. 02 for tisa-cel versus axi-cel (95% CI, 0. 75-1. 40) and no statistically significant difference.

Compared with tisa-cel, axi-cel had longer progression-free survival and overall survival, with risk ratios of 0. 70 (95% CI, 0. 62-0. 80) and 0. 71 (95% CI, 0. 61-0. 84) for axi-cel and tisa-cel, respectively. Compared with tisa-cel, axi-cel had higher incidence rates of cytokine release syndrome (CRS) and immune effector cell-related neurotoxicity syndrome (ICANS), with ORs of 3.

84 (95% CI, 2. 10-7. 03) and 4. 4 (95% CI, 2. 81-6. 91), respectively. CAR T-cell therapy is an effective treatment option for relapsed/refractory B-cell lymphoma. Axi-cel has better ORR and survival advantages compared with tisa-cel; however, axi-cel has higher incidence rates of CRS and ICANS compared with tisa-cel.