Comparable Outcomes of Point-of-Care and Commercial CD19 CAR-T Therapies: A Patient-Matched Analysis in Large B-Cell Lymphoma

Introduction: Point-of-care (POC) chimeric antigen receptor T-cell (CAR-T) therapy offers accessible treatment with a rapid vein-to-vein time. However, the efficacy of POC CAR-T compared to commercial CAR-T products remains uncertain. To address this, we compared an autologous CD19 POC CAR-T product...

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Published in:Blood 2024-11, Vol.144, p.608-608
Main Authors: Marcus, Ronit, Avigdor, Abraham, Greenbaum, Uri, Golan Accav, Noa, Shem-Tov, Noga, Yerushalmi, Ronit, Danylesko, Ivetta, Jacoby, Elad, Nagler, Arnon, Shimoni, Avichai, Ballweg, Annamaria, Deschênes-Simard, Xavier, Luttwak, Efrat, Shah, Gunjan L., Scordo, Michael, Dahi, Parastoo B, Perales, Miguel Angel, Zuckerman, Tsila, Henig, Israel, Yehudai-Ofir, Dana, Khatib, Hazim, Shouval, Roni, Beyar Katz, Ofrat
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Language:English
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Summary:Introduction: Point-of-care (POC) chimeric antigen receptor T-cell (CAR-T) therapy offers accessible treatment with a rapid vein-to-vein time. However, the efficacy of POC CAR-T compared to commercial CAR-T products remains uncertain. To address this, we compared an autologous CD19 POC CAR-T product with commercial alternatives in patients with large B-cell lymphoma (LBCL) using a patient-matched analysis. Methods: This retrospective international multicenter study included patients with large B-cell lymphoma (LBCL) treated with autologous CD19-directed CAR-T who had received at least two prior lines of therapy across three academic centers. The CAR-T products evaluated were two commercial products (Axi-cel and Tisa-cel) and an established POC product, based on CD28 costimulatory domain (NCT02772198, Kedmi et al., JTCT 2022). The commercial products were administered at all centers, while the POC product was used at one center until the commercial product was approved by the regulatory authorities and in specific subsequent cases. Primary outcomes were overall survival (OS) and progression-free survival (PFS) from the time of infusion. Products were compared using an inverse propensity-weighted model based on age, Karnofsky performance status (KPS), LDH levels, primary refractory disease, and transformed lymphoma. Results: A total of 330 patients were included in the study: 132 received Axi-cel, 104 received Tisa-cel, and 94 received the POC product. Patients treated with POC CAR-T were younger (median age 51 vs. 62 for Axi-cel and 69 for Tisa-cel, p
ISSN:0006-4971
DOI:10.1182/blood-2024-207638