Axi-cel outcome in treatment for R/R large B-cell lymphoma

Westin JR, Oluwole OO, Kersten MJ, et al. Survival with Axicabtagene Ciloleucel in Large B-Cell Lymphoma. New England Journal of Medicine. 2023; (doi: 10.1056/NEJMoa2301665).

The Phase III ZUMA-7 trial found that patients with early relapsed or refractory large B-cell lymphoma survived much longer without complications when administered axicabtagene ciloleucel (axi-cel) as a second-line treatment compared with standard care. A total of 359 patients were randomized to receive axi-cel (N=180) or standard care (N=179), which included two to three cycles of chemoimmunotherapy followed by high-dose chemotherapy with autologous stem-cell transplantation in responding patients. Among the patients, 73.5% had primary refractory disease, 30.4% had an age of 65 years or older, and 19.5% had high-grade B-cell lymphomas that included double-hit lymphomas. At a median follow-up of 47.2 months, the median overall survival (OS) had not yet been reached in the axi-cel group, compared with a median OS of 31.1 months in the standard care group. The two groups had respective estimated 4-year overall survival rates of 54.6% and 46.0%, corresponding with a 27.4% reduction in death with axi-cel therapy. Patients in the axi-cel group had a median progression-free survival (PFS) of 14.7 months compared with 3.7 months for the standard care group, with estimated 4-year PFS rate of 41.8% versus 24.4%. Since the primary analysis of event-free survival, no new treatment-related fatalities have been reported.

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Tags: transplantation, Cell, Cellular therapy, Refractory, Lymphoma, cell therapy, standard of care, survival rate