Care pathway of patients with second-line large B-cell lymphoma treated with CAR T-cell therapies in France

CAR T-cell therapies have transformed the management of relapsed/refractory large B-cell lymphoma (LBCL), with axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel) approved after first-line chemoimmunotherapy failure. Real-world data on their care pathway remain limited. This retrospective cohort study used the French national hospital claims database (PMSI) to describe the care pathway and healthcare resource utilization in patients receiving axi-cel or liso-cel as second-line therapy across 32 centers between 2022 and 2024. Among 823 patients (631 [76.7%] axi-cel, 192 [23.3%] liso-cel), bridging was longer with liso-cel (48.5 vs. 38.1 days) and early post-CAR T monitoring shorter (10.9 vs. 16.1 days). Liso-cel was associated with fewer ICU admissions (2.1% vs. 14.1%), less tocilizumab use, a cytokine release syndrome proxy (7.8% vs. 48.3%), and lower three-month rehospitalizations (54.4% vs. 78.1%). These descriptive data show lower hospital resource use with liso-cel than axi-cel as second-line LBCL therapy.