Matching-adjusted indirect comparison of axi-cel and liso-cel in relapsed or refractory large B-cell lymphoma

Abstract

In the absence of a randomized head-to-head trial, an unanchored matching-adjusted indirect comparison was performed to estimate the relative treatment effects of axicabtagene ciloleucel (axi-cel; ZUMA-1) versus lisocabtagene maraleucel (liso-cel; TRANSCEND-NHL-001) for treatment of relapsed/refractory (R/R) large B-cell lymphoma (LBCL) after at least two lines of therapy. After matching, axi-cel and liso-cel had comparable objective response rates and duration. Compared to liso-cel, axi-cel was associated with improvements in overall survival (hazard ratio [HR]: 0.53 [95% CI: 0.34–0.82]) and progression-free survival (HR: 0.61 [95% CI: 0.40–0.92]). Axi-cel was associated with a higher rate of grade ≥3 cytokine release syndrome (odds ratio [OR]: 3.64 [95% CI: 1.04–12.76]) and neurological events (OR: 3.45 [95% CI: 1.65–7.19]), with smaller differences estimated in scenario analyses including ZUMA-1 safety management cohorts. Results suggest axi-cel improved survival compared to liso-cel but with increased odds of specific adverse events.

Keywords:

• Large B-cell lymphoma
• axicabtagene ciloleucel
• lisocabtagene maraleucel
• CAR T-cell therapy
• MAIC
• comparative efficacy

Author contributions

All authors contributed to the study design, data analysis and interpretation, writing of the manuscript, and critical revision of the manuscript prior to submission.

Disclosure statement

OOO reports: Consultancy and advisory board for: Pfizer, Kite, Gilead, AbbVie, Janssen, TGR therapeutics, Novartis, curio science. Institution funding: Kite, Pfizer, Daichi Sankyo. Honoraria: Pfizer, Gilead. FLL reports: Scientific Advisory Role: Allogene, Amgen, Bluebird Bio, BMS/Celgene, Calibr, Cellular Biomedicine Group, GammaDelta Therapeutics, Iovance, Kite Pharma, Janssen, Legend Biotech, Novartis, Sana, Takeda, Wugen, Umoja; Research Funding: Kite Pharma (Institutional), Allogene (Institutional), Novartis (Institutional), BlueBird Bio (Institutional), BMS (Institutional), National Cancer Institute, Leukemia and Lymphoma Society; Patents, Royalties, Other Intellectual Property: Several patents held by the institution in my name (unlicensed) in the field of cellular immunotherapy; Consulting Role: Cowen, EcoR1, Emerging Therapy Solutions, Gerson Lehrman Group (GLG); Education or Editorial Activity: Aptitude Health, ASH, BioPharma Communications CARE Education, Clinical Care Options Oncology, Imedex, Society for Immunotherapy of Cancer. JMHC, KC, SK, and JPJ are PRECISIONheor employees funded by Kite, a Gilead Company for this study. ARP, YZ, and JTS are employees and equity owners of Kite, a Gilead Company.

Additional information

Funding

This study was sponsored by Kite, A Gilead Company.