Improved progression free survival after axicabtagene ciloleucel compared to tisagenlecleucel, in patients aged >70 years with large B-cell lymphoma.
Chimeric antigen receptor(CAR) T-cell therapy is effective in relapsed/refractory large B-cell lymphoma(LBCL), but evidence in elderly patients(≥70y) is limited. We compared outcomes of tisagenlecleucel(tisa-cel) and axicabtagene ciloleucel(axi-cel) and assessed prognostic factors. We analyzed 1,191 patients(aged ≥70y) reported to the EBMT(tisa-cel n=402; axi-cel n=789). Median follow-up was 22.7 months. Outcomes included cytokine release syndrome(CRS), immune effector cell-associated neurotoxicity syndrome(ICANS), overall survival(OS), progression-free survival(PFS), relapse incidence(RI), and non-relapse mortality(NRM). Multivariable models adjusted for age, sex, ECOG, disease status, prior transplantation, and year of infusion. Median age at infusion was 74y; 65.6% were aged 70-75y. Progressive disease at infusion was 59% vs 53% for tisa-cel and axi-cel(p=0.04). Tisa-cel patients were older(74.0 vs 73.7y, p=0.019). At day-30, CRS(any grade) occurred in 62% vs 77%(p.