Matching-adjusted indirect comparison (MAIC) of lisocabtagene maraleucel (liso-cel) versus axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) for treatment of third-line or later (3L+) R/R follicular lymphoma (FL): Update with 24 months of liso-cel follow-up (FU).

Abstract

e19049 Background: Liso-cel, axi-cel, and tisa-cel are FDA-approved chimeric antigen receptor T cell therapies for 3L+ R/R FL, but no head-to-head comparisons have been conducted. A previous MAIC (Boardman AP, et al. Blood 2024) with median FUs of 19.3 mo for liso-cel, 24.4 mo for axi-cel, and 16.85 mo for tisa-cel found liso-cel had a higher CR rate and similar ORR, PFS, and duration of response (DOR) versus axi-cel and tisa-cel. Here, we present updated results with longer FU for all 3 therapies, including additional comparisons of OS and time to next treatment (TTNT). Methods: MAICs estimated population-adjusted relative treatment effects for liso-cel (TRANSCEND FL; data cutoff for independent review committee [IRC]–assessed and investigator [INV]-assessed outcomes and safety was 10 Jan 2024; median FU, 30.0 mo) versus axi-cel (ZUMA-5; data cutoffs were 14 Sep 2020 [IRC-assessed outcomes and safety] and 31 Mar 2022 [INV-assessed outcomes]; median FU, 24.4 mo and 41.7 mo, respectively) and tisa-cel (ELARA; data cutoffs were 29 Mar 2021 [safety] and 29 Mar 2022 [IRC-assessed outcomes]; median FU, 16.6 and 28.9 mo, respectively). Baseline characteristics and outcomes in TRANSCEND FL were redefined to align with ZUMA-5 and ELARA. TRANSCEND FL data were weighted by a method-of-moments propensity score model. Response ratios (RR) or HRs with corresponding 95% CIs were used to compare response, time-to-event, and safety outcomes. Results: Comparing IRC-assessed outcomes with axi-cel, liso-cel showed a higher CR rate (RR, 1.26; 95% CI, 1.09–1.45) and a similar ORR (RR, 1.06; 95% CI, 1.00–1.12). Liso-cel also exhibited comparable DOR (HR, 1.21; 95% CI, 0.54–2.75), PFS (HR, 1.13; 95% CI, 0.50–2.53), and OS (HR, 0.51; 95% CI, 0.13–2.00). INV-assessed outcomes demonstrated a higher CR rate for liso-cel and similar ORR. Further, liso-cel showed numerically favorable DOR (HR, 0.83; 95% CI, 0.41–1.67), PFS (HR, 0.76; 95% CI, 0.38–1.54), OS (HR, 0.63; 95% CI, 0.20–1.97), and TTNT (HR, 0.51; 95% CI, 0.22–1.19). Comparing liso-cel with tisa-cel based on IRC-assessed outcomes, liso-cel had a higher CR rate (RR, 1.37; 95% CI, 1.08–1.72) and a comparable ORR (RR, 1.10; 95% CI, 0.96–1.25), DOR (HR, 0.95; 95% CI, 0.38–2.38), PFS (HR, 0.86; 95% CI, 0.38–1.95), OS (HR, 0.81; 95% CI, 0.20–3.28), and TTNT (HR, 0.88; 95% CI, 0.31–2.46). Safety analysis results were consistent with the previously reported MAIC publication. Conclusions: After incorporating longer FU data and adjusting for population differences, liso-cel had a higher CR rate versus axi-cel and tisa-cel, and comparable or numerically favorable ORR, DOR, PFS, OS, and TTNT. Liso-cel had a more favorable safety profile versus axi-cel and a similar safety profile compared with tisa-cel. Clinical trial information: NCT04245839 , NCT03105336 , NCT03568461 .