Outcomes of second-line axicabtagene ciloleucel for large B-cell lymphoma in the UK.

Kuhnl, A.; Kirkwood, AA.; Northend, M.; Besley, C.; Uttenthal, B.; Norman, J.; Hiew, H.; Seymour, F.; Maybury, B.; Osborne, W.; Sillito, F.; Abdulgawad, A.; Jones, C.; McCarthy, P.; Panopoulou, A.; Gribben, JG.; Bataillard, E.; Martinez-Calle, N.; Gajendran, L.; O'Reilly, M.; Kumar, E.; Wilson, RP.; Kasivisvanathan, S.; Fadlelmula, N.; Pryce, A.; Awofisayo, O.; Maraj, A.; Townsend, W.; Cwynarski, K.; Paneesha, S.; Mathew, A.; Dulobdas, V.; El-Sharkawi, D.; Creasey, T.; Warren, M.; Malladi, R.; Owen, M.; Waraich, M.; Ediriwickrema, K.; Froggatt, J.; Delaney, A.; Davies, AJ.; Alajangi, R.; Collins, GP.; Sanderson, R.; Roddie, C.; Menne, T.; Chaganti, S.

Outcomes of second-line axicabtagene ciloleucel for large B-cell lymphoma in the UK.

All Authors

Kuhnl, A.

Kirkwood, AA.

Northend, M.

Besley, C.

Uttenthal, B.

Norman, J.

Hiew, H.

Seymour, F.

Maybury, B.

Osborne, W.

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LTHT Author

Seymour, Frances
Awofisayo , Olateni
Owen, Mary

LTHT Department

Leeds Cancer Centre
Oncology
Haematology

Publication Date

2026

Item Type

Journal Article

Subject

HOSPITALISATION

Abstract

Following approval of axicabtagene ciloleucel (axi-cel) as second-line (2 L) treatment for large B-cell lymphoma (LBCL), results from real-world CAR T cohorts will be key to confirm safety and efficacy in standard practice. We present comprehensive clinical outcomes of LBCL patients intended to be treated with 2 L axi-cel through the UK National CAR T service. Of 345 patients approved for 2 L axi-cel, 302 (87.5%) were infused. The median age was 62 years (range 22-78); 21% were over 70 years. 75% of patients were approved for CAR T within 3 months from end of first-line (1 L) therapy. 42% of patients required pre-apheresis holding therapy, and 97% received bridging therapy. The best overall response rate was 86% (64% complete response). The 12-month OS was 73.9% (95% CI: 68.3-78.7) for infused patients and 1.5 months (0.9-3.0) for patients not proceeding to CAR T. The 12-month PFS was 52.4% (46.3-58.0). In multivariable analysis, advanced stage, male sex, no response to 1 L therapy, high LDH, and high CRP pre-infusion were independently associated with PFS. Grade >=3 CRS and ICANS rates were 5% and 18%, respectively. Outcomes in patients aged >=70 years were similar to the younger population. In this large UK real-world cohort of 2 L axi-cel in LBCL, we demonstrate efficacy and toxicity outcomes comparable to the pivotal ZUMA-7 trial, despite 42% patients requiring urgent holding therapy. Outcomes were favorable in patients aged >=70 years, supporting the use of 2 L CAR T in older fit patients.