Dr. Koehne on Axi-Cel Vs Tisa-Cel in Relapsed/Refractory Diffuse Large B-Cell Lymphoma

Guenther Koehne, MD, PhD, deputy director and chief of stem cell transplantation, hematologic oncology and benign hematology at Miami Cancer Institute, discusses the real-life study of CAR T-cell agents axicabtagene ciloleucel (axi-cel; Yescarta) vs tisagenlecleucel (tisa-cel; Kymriah) in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

The 2021 ASH Annual Meeting and Exposition produced plenty of intrigue around CAR T-cell agents, according to Koehne. One analysis of particular interest was a propensity score–matched comparison from the French DESCAR-T registry (NCT04328298) of axi-cel and tisa-cel in patients with relapsed or refractory DLBCL, Koehne says. It is unknown how all CAR T-cell therapies definitively measure up against one another, Koehne adds.

Data from the randomized study showed that axi-cel elicited higher response rates in this population; however, the product was also associated with a higher rate of adverse effects, such as immune effector cell–associated neurotoxicity syndrome and cytokine release syndrome, when compared with tisa-cel, Koehne explains. Furthermore, axi-cel and tisa-cel produced similar overall survival rates, raising questions about how to optimally choose between the 2 therapies, Koehne says. 

However, potential strategies may be able to inform which products to use in different patient populations, Koehne adds. For example, tisa-cel could be a strong option for older patients with more comorbidities, and axi-cel might be ideal for younger patients with less aggressive lymphomas, Koehne concludes.