Clinical outcomes with axi-cel by race and ethnicity
Locke FL, Siddiqi T, Jacobson CA, et al. Real-World and Clinical Trial Outcomes in Large B-Cell Lymphoma With Axicabtagene Ciloleucel Across Race and Ethnicity. Blood. 2024; (doi: 10.1182/blood.2023023447).
Clinical trial results indicate that overall survival and safety outcomes with axicabtagene ciloleucel (axi-cel) are similar across lymphoma patient populations regardless of race, but researchers observed differences within real-world contexts. Their sample involved 1,290 patients with large B-cell lymphoma (LBCL) treated with autologous, CD19-directed chimeric antigen receptor T-cell therapy between 2017 and 2020, including 106 participants from the ZUMA-1 study and 169 participants from ZUMA-7. The findings yielded important considerations for clinicians administering axi-cel to patients with relapsed/refractory LBCL. Non-Hispanic African Americans demonstrated lower overall response rates (OR, 0.37, [95% CI, 0.22-0.63]) and complete response rates (OR, 0.57, [95% CI, 0.33-0.97]) compared with Non-Hispanic White patients, and shorter progression-free survival compared with Non-Hispanic Whites (HR, 1.41, [95% CI, 1.04-1.90]) and Non-Hispanic Asians (HR, 1.67, [95% CI, 1.08-2.59]). Additionally, a longer duration of response was documented in Non-Hispanic Asians versus Hispanic patients (HR, 0.54, [95% CI, 0.30-0.97]) and Non-Hispanic White patients (HR, 0.56, [95% CI, 0.33-0.94]). Overall survival and the incidence of cytokine release syndrome were not remarkably different across race/ethnicity, but Non-Hispanic White patients were more likely to develop immune cell-associated neurotoxicity syndrome than other groups.