The following is a summary of “Real-World and Clinical Trial Outcomes in Large B-cell Lymphoma with Axicabtagene Ciloleucel Across Race and Ethnicity,” published in the April 2024 issue of Hematology by Locke et al.
Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for treating relapsed/refractory (R/R) large B-cell lymphoma (LBCL). Despite extensive data supporting its efficacy in patients with LBCL, there needs to be more information on outcomes stratified by race and ethnicity. This study presents clinical outcomes of axi-cel treatment in patients with R/R LBCL from both real-world and clinical trial settings, focusing on race and ethnicity.
In the real-world analysis, data from 1,290 R/R patients with LBCL who received axi-cel between 2017 and 2020 were obtained from the Center for International Blood and Marrow Transplant Research database. Additionally, 106 and 169 patients from the ZUMA-1 and ZUMA-7 clinical trials, respectively, were included. Adjusted odds ratios (ORs) and hazard ratios (HRs) for different race and ethnicity groups are reported.
Overall survival rates were consistent across all race/ethnicity groups. However, non-Hispanic (NH) Black patients exhibited lower overall response rates (OR 0.37, [95% CI, 0.22-0.63]) and lower complete response rates (OR 0.57, [95% CI, 0.33-0.97]) compared to NH-white patients. NH-Black patients also had shorter progression-free survival than NH-white (HR 1.41, [95% CI, 1.04-1.90]) and NH-Asian patients (HR 1.67, [95% CI, 1.08-2.59]). NH-Asian patients, on the other hand, had a longer duration of response compared with NH-white (HR 0.56, [95% CI, 0.33-0.94]) and Hispanic patients (HR 0.54, [95% CI, 0.30-0.97]).
Cytokine release syndrome did not show significant differences by race/ethnicity. However, NH-white patients had higher rates of any-grade immune effector cell-associated neurotoxicity syndrome compared to other patients.
These findings underscore the importance of considering racial and ethnic differences when administering axi-cel therapy to patients with R/R LBCL, providing valuable insights for clinical practice.