Patients with large B-cell lymphoma (LBCL) who receive CAR T therapy in real-world settings may experience lower rates of treatment adverse such as cytokine release syndrome (CRS) and anemia than patients who receive CAR T therapy in clinical trials, according to a study presented at the 2022 ASCO Quality Care Symposium in Boston in October.
Researchers at Qualia Bio in Los Angeles conducted a retrospective cohort analysis of Medicare claims data to compare real-world CAR T outcomes with results from clinical trials. They identified 463 fee-for-service Medicare beneficiaries with LBCL who were treated with one of three U.S. Food and Drug Administration–approved CAR T therapies (tisa-cel, axi-cel, or liso-cel) between January 2020 and March 2021.
Real-world patients tended to be older (90% aged 65 or older) than those treated in clinical trials, in which 22% to 42% of patients were aged 65 or older. Real-world patients were also more likely to be female; 57% of real-world patients were male compared with 65% of those in clinical trials.
CRS occurred in 26% of real-world patients compared with 93% of clinical-trial participants who received axi-cel, 58% for tisa-cel, and 42% for lisa-cel. Anemia occurred in 31% of real-world patients versus 66% of those receiving axi-cel and 48% for tisa-cel or liso-cel in clinical trials. Real-world patients also experienced lower rates of adverse effects such as neutropenia, fatigue, and thrombocytopenia compared with clinical-trial participants who received axi-cel or liso-cel. Twelve-month survival was comparable among the two groups of patients (59% for both real-world patients and those receiving axi-cel in clinical trials, 58% for tisa-cel, 42% for liso-cel).
- McBride K, Snyder S. Real-world versus clinical trial CAR T outcomes among patients diagnosed with diffuse large B-cell lymphoma. J Clin Oncol 2022 01 Oct;40(28)suppl:413. doi: 10.1200/JCO.2022.40.28_suppl.413