Matching-adjusted indirect comparison of lisocabtagene maraleucel versus axicabtagene ciloleucel for second-line treatment of patients with early relapsed or refractory large B-cell lymphoma

In the absence of head-to-head trials of chimeric antigen receptor T-cell therapies, a matching-adjusted indirect comparison (MAIC) evaluated the comparative efficacy and safety of lisocabtagene maraleucel (liso-cel) versus axicabtagene ciloleucel (axi-cel) as second-line (2L) therapies in patients with early relapsed or refractory (R/R) large B-cell lymphoma (LBCL). Data sources were the pivotal phase 3 trials: individual patient-level data from TRANSFORM [liso-cel (NCT03575351), <i>N</i> = 184] and summary-level data from ZUMA-7 [axi-cel (NCT03391466), <i>N</i> = 359]. Efficacy analyses were anchored <i>via</i> the common standard-of-care comparator arms and showed no statistically significant differences. Safety analyses were unanchored, showing liso-cel had lower odds (95% confidence interval) of grade ≥3 serious treatment-emergent adverse events [0.49 (0.27-0.90)], cytokine release syndrome [any grade, 0.09 (0.04-0.18); grade ≥3, 0.09 (0.01-0.75)], and neurological events [any grade, 0.08 (0.03-0.18); grade ≥3, 0.21 (0.06-0.68)]. In this MAIC, liso-cel demonstrated comparable efficacy and a more favorable safety profile versus axi-cel for 2L treatment of R/R LBCL.