Year: 2026
Type: article
Study design: Observational Study
Abstract: Following approval of axicabtagene ciloleucel (axi-cel) as second-line (2 L) treatment for large B-cell lymphoma (LBCL), results from real-world CAR T cohorts will be key to confirm safety and efficacy in standard practice. We present comprehensive clinical outcomes of LBCL patients intended to be treated with 2 L axi-cel through the UK National CAR T service. Of 345 patients approved for 2 L axi-cel, 302 (87.5%) were infused. The median age was 62 years (range 22-78); 21% were over 70 years. 75% of patients were approved for CAR T within 3 months from end of first-line (1 L) therapy. 42% of patients required pre-apheresis holding therapy, and 97% received bridging therapy. The best overall response rate was 86% (64% complete response). The 12-month OS was 73.9% (95% CI: 68.3-78.7) for infused patients and 1.5 months (0.9-3.0) for patients not proceeding to CAR T. The 12-month PFS was 52.4% (46.3-58.0). In multivariable analysis, advanced stage, male sex, no response to 1 L therapy, high LDH, and high CRP pre-infusion were independently associated with PFS. Grade ≥3 CRS and ICANS rates were 5% and 18%, respectively. Outcomes in patients aged ≥70 years were similar to the younger population. In this large UK real-world cohort of 2 L axi-cel in LBCL, we demonstrate efficacy and toxicity outcomes comparable to the pivotal ZUMA-7 trial, despite 42% patients requiring urgent holding therapy. Outcomes were favorable in patients aged ≥70 years, supporting the use of 2 L CAR T in older fit patients.
Source: HemaSphere
DOI: 10.1002/hem3.70312
Authors: Andrea Kuhnl, Amy A. Kirkwood, Michael Northend, Caroline Besley, Ben Uttenthal, Jane Norman, Hwai Hiew, Frances Seymour, Bernard Maybury, Wendy Osborne, Francesca Sillito, Ahmed Abdulgawad, Ceri Jones, Pierre McCarthy, Aikaterini Panopoulou, John G. Gribben, Edward Bataillard, Nicolas Martinez‐Calle, Lavanya Gajendran, Maeve O'Reilly, Emil Kumar, Robert P. Wilson, Shenbagaram Kasivisvanathan, Nada Fadlelmula, Angharad Pryce, Olateni Awofisayo, Adrian Maraj, William Townsend, Kate Cwynarski, Shankara Paneesha, Amrith Mathew, Vaishali Dulobdas, Dima El‐Sharkawi, Thomas Creasey, Mary Warren, Ram Malladi, Mary Owen, Muddeha Waraich, Kushani Ediriwickrema, Joseph Froggatt, Alison Delaney, Andrew J. Davies, Rajesh Alajangi, Graham P. Collins, Robin Sanderson, Claire Roddie, Tobias Menne, Sridhar Chaganti
Institutions: King's College Hospital, University College London, University Hospitals Bristol and Weston NHS Foundation Trust, University of Cambridge, Cambridge University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, University Hospital Southampton NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, Freeman Hospital, Newcastle University, Royal Marsden Hospital, The Christie Hospital, University Hospital of Wales, Sheffield Teaching Hospitals NHS Foundation Trust, University of Oxford, Oxford University Hospitals NHS Trust, Queen Mary University of London, Barts Cancer Institute, Imperial College Healthcare NHS Trust, Nottingham University Hospitals NHS Trust, St George's Hospital
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,480
OpenAlex ID: W7130509428