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Comparative Study
. 2025 Feb 11;9(3):455-462.
doi: 10.1182/bloodadvances.2024012992.

A real-world comparison of commercial-use axicabtagene ciloleucel and lisocabtagene maraleucel in large B-cell lymphoma

Andrew Looka  1 , David A Qualls  1 , Daniel Matthews  1 , Robert A Redd  2 , Christopher Sakellis  3 , Caitlyn Duffy  1 , Jamie Dela Cruz  1 , Anna Saucier  1 , Philippe Armand  1 , Jennifer L Crombie  1 , David C Fisher  1 , Eric D Jacobsen  1 , Austin I Kim  1 , Ann S LaCasce  1 , Reid W Merryman  1 , Erin M Parry  1 , Caron A Jacobson  1
Affiliations
Comparative Study

A real-world comparison of commercial-use axicabtagene ciloleucel and lisocabtagene maraleucel in large B-cell lymphoma

Andrew Looka et al. Blood Adv. .

Abstract

Lisocabtagene maraleucel (liso-cel) and axicabtagene ciloleucel (axi-cel) are anti-CD19 chimeric antigen receptor (CAR) T-cell therapies approved for relapsed and refractory large B-cell lymphoma (LBCL); however, there is currently no published data on liso-cel outside of clinical trials nor any data comparing these therapies. In this retrospective analysis, we reviewed patients with LBCL receiving liso-cel or axi-cel at a single institution in the third-line setting. From June 2021 to September 2022, a total of 50 patients received axi-cel and 37 liso-cel. Baseline patient characteristics were similar, aside from older age in liso-cel recipients. The median time from leukapheresis to CAR T-cell infusion was significantly longer for liso-cel (41 days) than axi-cel (30 days). Complete response rates were not significantly different between axi-cel (72%) and liso-cel (62%). At a median follow-up of 11 months, progression-free survival (PFS) was not significantly different between axi-cel and liso-cel cohorts, with 12-month PFS of 59% and 44%, respectively. However, on a propensity score analysis, an inferior PFS was observed with liso-cel (hazard ratio, 2.95; 95% confidence interval , 1.14-7.60). The rates of cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, and prolonged neutropenia were higher with axi-cel than liso-cel. Overall, direct comparison of axi-cel and liso-cel cohorts shows similar key outcomes including response rate and PFS, but prolonged wait times for liso-cel may have resulted in biased selection of patients with more favorable characteristics for liso-cel. When accounting for these higher-risk characteristics, an inferior PFS is observed with liso-cel compared with axi-cel. These findings warrant further evaluation in a multicenter setting.

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Conflict of interest statement

Conflict-of-interest disclosure: D.Q. reports advisory board fees from Genmab and ADC Therapeutics. P.A. reports consulting roles for Merck, Bristol Myers Squibb (BMS), Pfizer, Affimed, Adaptive, Infinity, ADC Therapeutics, Celgene, MorphoSys, Daiichi Sankyo, Miltenyi, Tessa, Genmab, C4, Enterome, Regeneron, Epizyme, AstraZeneca, Genentech/Roche, Xencor, Foresight, and ATB Therapeutics; research funding from Kite, Merck, BMS, Affimed, Adaptive, Tensha, Otsuka, Sigma Tau, Genentech/Roche, IGM Biosciences, and AstraZeneca; and honoraria from Merck and BMS. J.L.C. reports consulting fees from ADC Therapeutics, Seagen, Kite, Incite/MorphoSys, and Regeneron, and research funding from Genentech/Roche, Merck, AbbVie, and Bayer. E.D.J. reports consulting fees from Syros and Takeda, and research funding from Acerta, Janssen, Novartis, and Pharmacyclics. A.S.L. reports advisory board fees from Kite and Seagen; consulting fees from Research to Practice, Genmab, Adaptive Biotechnologies, BMS, AbbVie, Intellia, and Epizyme; and research funding from BMS, Merck, Genentech/Roche, and Genmab. C.A.J. served as a consultant for Kite/Gilead, Novartis, BMS/Celgene, Abintus Bio, ImmPACT Bio, Caribou Bio, MorphoSys, ADC Therapeutics, AbbVie, AstraZeneca, Ipsen, Sana, Synthekine, Daiichi Sankyo, and Janssen, and has received research funding from Kite/Gilead and Pfizer. The remaining authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Survival outcomes. Kaplan-Meier curves illustrating time-to-event for the overall cohort and comparing axi-cel and liso-cel cohorts. (A) DOR curves for patients who achieved a CR or PR at first restaging after therapy. (B) PFS curves. (C) OS curves. IEC, immune effector cell.
Figure 2.
Figure 2.
Weighted comparison of clinical outcomes. (A-B) Propensity score-weighted comparison of outcomes between axi-cel and liso-cel cohorts, including ORs for ORR and CRR (A), as well as HRs for OS and PFS (B).
See this image and copyright information in PMC

References

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