Key Clinical Summary:

• Design/Population: A retrospective cost-consequence and time-toxicity analysis compared axicabtagene ciloleucel (axi-cel) with bispecific antibodies (glofitamab, epcoritamab) in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) treated in the third-line or later setting in the United States.
• Key Outcomes: Axi-cel, as a one-time CAR T-cell therapy, was associated with substantially lower annualized time toxicity, including fewer treatment days, fewer healthcare visits, and reduced travel burden (fewer trips and miles traveled) compared with glofitamab (fixed 12-month therapy) and epcoritamab (indefinite therapy). Despite short-term driving restrictions after CAR-T, overall travel and time demands remained lower with axi-cel.
• Clinical Relevance: For eligible patients with R/R DLBCL, axi-cel may offer advantages beyond efficacy, including reduced time burden and logistical impact compared with bispecific antibodies, highlighting the importance of incorporating time toxicity and patient convenience into shared decision-making when selecting advanced therapies.

Olalekan Oluwole, MD, MBBS, Vanderbilt University Medical Center, Nashville, Tennessee, presented a cost, time, and travel burden analysis comparing axicabtagene ciloleucel (axi-cel) CAR T-cell therapy with bispecific antibodies, glofitamab and epcoritamab, for patients with relapsed/refractory (R/R) diffuse large b-cell lymphoma (DLBCL) in the third line or later at the 2025 American Society of Hematology (ASH) Annual Meeting & Exposition in Orlando, Florida.

The study found that axicabtagene ciloleucel was associated with substantially lower time toxicity, fewer treatment visits, and reduced travel burden compared with ongoing bispecific antibody therapy. 

Dr Oluwole concluded, “We know that being a one-time therapy accessor was actually associated with a lower need for travel, less miles, fewer specific days spent in the healthcare facility receiving treatment, compared to glofitamab and epcoritamab.”

Transcript:

Hello, I am Olalekan Oluwole, Associate Professor of Medicine, Vanderbilt University Medical Center. I'll be talking about my abstract number 6194, which is titled "US Cost Consequence and Time Toxicity Model for Advanced Therapies in the Treatment for Relapsed/Refractory Third-Line or Later Diffuse Large B-Cell Lymphoma: A Comparison of Axicabtagene Ciloleucel With Bispecific Antibodies." This was a work that my colleagues and I put together and is at the ASH meeting.

We all know that CAR-T has become a really good treatment in patients with relapsed/refractory large B-cell lymphoma and it can be curative in patients who otherwise had no real options. We also know that it is moving into standard of care, but we do know also that bispecific antibodies, particularly glofitamab and epcoritamab, are also now approved in the third line setting or later.

The purpose of this retrospective analysis was just to ask ourselves 1 simple question. If they had axi-cel, which is CAR-T or they had glofitamab or epcoritamab, what are the implications of the time to treatment time during treatment? All of those variables that we can anticipate will be different between the 2 types of treatment afterall a CAR-T is a 1-time treatment while these bispecifics that given indefinitely for epcoritamab or for 12 months for glofitamab.

What we found was that axi-cel, in terms of report, axi-cel was associated with much lower per patient annual analyzed time toxicity in terms of days compared to epcoritamab and glofitamab. We also found that patients who were on epcoritamab or glofitamab had to travel many, many more times to the treatment centers to get their treatment and the travel burden was much less for axi-cel, which is a CAR-T, compared to the bispecific antibodies and patients ended up traveling fewer miles in total when they received axi-cel compared to glofitamab and epcoritamab.

That makes sense because axi-cel is a one-time treatment even though they come frequently or they travel, but they're close to the healthcare area for 14 days, unlike the glofitamab that people could literally be traveling from anywhere. When we also looked at the driving restriction, because there are some driving restrictions with axi-cel compared to glofitamab and epcoritamab, but because the miles are actually fewer, that becomes not as big a deal compared to all of these products.

What we concluded from the study was that for patients with relapsed/refractory DLBCL in the third line or later setting, there is clearly superior efficacy and more long-term data with axi-cel compared to glofitamab or epcoritamab. We know that being a 1-time therapy accessor was actually associated with a lower need for travel, less miles, fewer specific days spent in the healthcare facility receiving treatment compared to glofitamab and epcoritamab. We think that this makes sense because axi-cel is a CAR-T given one time versus glofitamab and epcoritamab that are given either for 12 months or indefinitely.

Thank you very much.

Source:

Oluwole O, Benner J, Palivela M, et al. US cost consequence and time toxicity model for advanced therapies in the treatment for Relapsed/Refractory third-line or later diffuse large B-cell lymphoma: A comparison of axicabtagene ciloleucel with bispecific antibodies. Dec 6-9, 2025; Orlando, FL. Abstract: 6194