Abstract
Purpose
Chimeric antigen receptor (CAR) T-cell products (eg, tisagenlecleucel [tisa], axicabtagene
ciloleucel [axi]) have been used in patients with relapsed/refractory large B-cell
lymphoma (LBCL) and in adult patients with acute lymphoblastic leukemia (ALL). After
the recent publication of long-term follow-up data in LBCL, reviewing the evidence
on this topic is worthwhile. The aim of the present work was to study the pattern
of overall survival (OS) reported for CAR T-cell products in LBLC and ALL.
Methods
A standard literature search was performed. OS was studied through an artificial intelligence
technique (the Shiny method) that reconstructs individual patient data from published
Kaplan-Meier curves. Standard statistics along with indirect comparisons were performed
on these reconstructed data. Indirect comparisons focused on CAR T cells versus chemotherapy
in LBCL and ALL; tisa and axi were further indirectly compared in LBCL.
Findings
Seven trials were included (4 for LBCL, 3 for ALL). Other populations were selected
as control groups. The main results of our analysis were: (1) the survival advantage
of CAR T cells is greater in adult patients with ALL than in patients with LBCL; and
(2) for LBCL, the survival gain is more substantial for axi compared with tisa.
Implications
Our results are helpful to define the place in therapy of CAR T cells in these 2 disease
conditions and also suggest preliminary estimates of cost-effectiveness. One strength
of our analysis is that extensive information was available for the treatment options
included in indirect comparisons. The main weakness is the inability of the Shiny
method to perform multivariate analyses.
Key words
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Article info
Publication history
Published online: December 09, 2022
Accepted:
November 2,
2022
Identification
Copyright
© 2022 Elsevier Inc.
