Systematic literature review of clinical outcomes, health-related quality of life, and healthcare costs and resource use in relapsed/refractory large B-cell lymphoma treated with axicabtagene ciloleucel.

Abstract

The approval of axicabtagene ciloleucel (axi-cel) for use in second-line (2L) relapsed/refractory (R/R) large B-cell lymphoma (LBCL), emerging real-world evidence provides clinical and economic insights. We conducted a systematic review of studies reporting such outcomes among patients with treated with axi-cel in 2L and 2L + R/R LBCL. In routine care, axi-cel shows effectiveness comparable to clinical trials, with a lower rate of serious cytokine release syndrome in real-world 2L populations. Most real-world studies reported similar or lower incidence of neurological complications despite their broader populations. Patient-reported data indicate an early, transient health-related quality of life (HRQoL) decline followed by improvements over baseline in multiple domains. HRQoL gains were consistent with or exceeded trial results. Early economic analyses suggest that outpatient administration may offer a lower-cost option than inpatient infusions for some patients. Overall, these findings inform healthcare decision-making and support the use of axi-cel in routine clinical practice.