Choice of commercially available CAR-T cell products for r/r DLBCL & PMBCL in Europe: a survey on behalf of the cellular therapy & immunobiology working party (CTIWP) of the EBMT

Since summer 2018, three CAR-T cell products have been approved by the EMA to treat aggressive B-cell lymphomas, DLBCL, either de novo or tFL and PMBCL: tisagenlecleucel (tisacel), axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel) [1–3]. Tisa-cel, axi-cel, and liso-cel are approved for the treatment of adult patients with relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) (and primary mediastinal large B-cell lymphoma (PMBCL) for axi-cel and liso-cel). More recently, axi-cel and liso-cel were additionally approved for the treatment of adult patients with DLBCL and high-grade B-cell lymphoma (HGBL) (and PMBCL for liso-cel) that relapses within 12 months from completion of, or is refractory to, first-line chemoimmunotherapy [2, 4, 5]. While the exact labelings of these products are different, there is a considerable overlap in product attributes and indications. There is so far no formal recommendations by medical experts or societies regarding the choice of one CAR-T cell product over another and no randomized trial addressed nor is likely to address the issue of the choice of the CAR-T cell products. Therefore, to evaluate the real-world practices of the usage of CAR-T cells in aggressive lymphomas and capture the criteria used by centers to guide their choice of a product for a given patient, we conducted a survey on behalf of the Cellular Therapy and Immunobiology Working Party (CTIWP) of the EBMT.