COMPARATIVE EFFECTIVENESS OF SALVAGE CHEMOTHERAPY AND CHIMERIC ANTIGEN T‐CELL RECEPTOR THERAPIES IN R/R DLBCL: A SYSTEMATIC REVIEW AND NETWORK META‐ANALYSIS

David Hodgson and John Kuruvilla are co-senior investigators Introduction: The optimal salvage chemotherapy (SC) regimen for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) prior to autologous stem cell transplant (ASCT) remains unclear. Head-to-head comparison of chimeric antigen receptor T (CAR-T) therapies second line use in primary DLBCL is lacking. Given these limitations, we conducted a systematic review network meta-analysis (NMA) randomized clinical trials (RCTs) assess the efficacy safety SC CAR-T R/R DLBCL. Methods: We searched MEDLINE, EMBASE CENTRAL from Jan 1 2006 July 7 2022 RCTs enrolling patients diagnosed with following treatment (trt) at least regimen. outcome was overall survival (OS), secondary outcomes were progression free (PFS) grade ≥ 3 adverse events (AEs). NMA using fixed-effect model synthesize evidence. Surface under cumulative ranking curve used rank relative effect compared trt. Results: A total 22 (n=4505) met eligibility criteria, 13 included qualitative synthesis only. (6 RCTs, n=1831) trt: GDP (gemcitabine, dexamethasone, cisplatin), rituximab (R)-GDP, ICE (ifosfamide, mesna, carboplatin, etoposide), R-ICE, DHAP (dexamethasone, cytarabine, R-DHAP, ofatumumab (O)-DHAP, ESHAP (etoposide, cisplatin, methylprednisolone). Results indicated that R-GDP had improved OS PFS over other regimens (Table), ranked highest PFS. AEs showed no differences infection. (axi-cel, liso-cel, tisa-cel; n=733) axi-cel liso-cel ASCT, while difference observed. Comparing between products, both tisa-cel. Liso-cel tisa-cel higher risk cytokine release syndrome SC, neurologic toxicity SC. Conclusions: Our results suggest may be ASCT. Both did not. Although PFS, longer follow-up required comparative analysis as data matures. Keywords: Aggressive non-Hodgkin lymphoma, Therapeutics Clinical Trials Lymphoma - Other No conflicts interests pertinent abstract.