A real-world comparison of tisagenlecleucel and axicabtagene ciloleucel CAR T cells in relapsed or refractory diffuse large B cell lymphoma.

Antigens, CD19 Biological Products / adverse effects Clinical Studies as Topic Cytokine Release Syndrome Humans Immunotherapy, Adoptive / adverse effects Lymphoma, Large B-Cell, Diffuse / pathology Receptors, Chimeric Antigen / therapeutic use Retrospective Studies T-Lymphocytes

Journal

Nature medicine

ISSN: 1546-170X

Titre abrégé: Nat Med

Pays: United States

ID NLM: 9502015

Informations de publication

Date de publication:
10 2022

Historique:

received: 29 03 2022

accepted: 26 07 2022

pubmed: 23 9 2022

medline: 15 10 2022

entrez: 22 9 2022

Statut: ppublish

Résumé

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.

Identifiants

DOI: 10.1038/s41591-022-01969-y PMID: 36138152 PMC: PMC9556323

pubmed: 36138152

doi: 10.1038/s41591-022-01969-y

pii: 10.1038/s41591-022-01969-y

pmc: PMC9556323

doi:

Substances chimiques

Antigens, CD19 0

Biological Products 0

Receptors, Chimeric Antigen 0

tisagenlecleucel Q6C9WHR03O

axicabtagene ciloleucel U2I8T43Y7R

Banques de données

ClinicalTrials.gov

['NCT04328298']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

2145-2154

Commentaires et corrections

Type : CommentIn

Informations de copyright

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