EHA 2023 | Real-world comparison of axi-cel and tisa-cel in R/R DLBCL
Nico Gagelmann, MD, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, comments on the results of a comparative analysis of axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) using real-world data. The results showed that axi-cel was more efficacious than tisa-cel, but it was also associated with a higher rate of severe neurotoxicity. This interview took place at the 28th Congress of the European Hematology Association (EHA) 2023 in Frankfurt, Germany.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript (edited for clarity)
So, what we did is we looked at the recent real-world comparisons of axi-cel versus tisa-cel. There are prospective trials, but we are sure that there will never be a prospective, randomized, controlled trial comparing axi-cel versus tisa-cel, because of the money and the organization and everything. There have been in history, there have been paired matched-adjusted comparisons, indirect comparisons, but these comparison studies, they have problems on their own, they have methodological problems...
So, what we did is we looked at the recent real-world comparisons of axi-cel versus tisa-cel. There are prospective trials, but we are sure that there will never be a prospective, randomized, controlled trial comparing axi-cel versus tisa-cel, because of the money and the organization and everything. There have been in history, there have been paired matched-adjusted comparisons, indirect comparisons, but these comparison studies, they have problems on their own, they have methodological problems. So that’s why we tried to investigate the synthesized evidence on the comparative trials in the real-world setting of axi-cel versa tisa-cel.
And the message was quite clear, luckily, that axi-cel was significantly associated with better efficacy but also significantly associated, especially, with higher neurotoxicity, with higher severe neurotoxicity. But in the end, we are sure that the overall results, the overall efficacy results, they speak for axi-cel despite of the higher non-relapse mortality and the safety issues. It’s all a matter of timely investigation of the patient and careful selection of the patient. Most of the patients will, despite of these results, will receive axi-cel from now on. There will be a small cohort where patients will be selected for tisa-cel – maybe they are too comorbid and everything – but most of the patients will receive axi-cel.
Read more...
