Beneficio del Tisagenlecleucel vs Axicabtagene ciloleucel en pacientes con Linfoma de células B: Revisión sistemática

Abstract

Introduction Large B-cell lymphoma (LBCL) is a type of non-Hodgkin lymphoma that accounts for 4% of all cancers worldwide; conventional treatments, such as chemotherapy and stem cell transplantation, are not viable for many patients with refractory or relapsed LBCL, leading to the development of CAR-T therapies. These therapies, such as Tisagenlecleucel and Axicabtagene Ciloleucel, offer new alternatives for patients who are not eligible for transplants. General Objective To determine the benefit of tisagenlecleucel versus axicabtagene ciloleucel in patients with B-cell lymphoma through a qualitative systematic review. Methodology A systematic review was conducted based on the PRISMA 2020 guidelines, selecting studies from PubMed and Cochrane published in the last five years in English and Spanish. The inclusion and exclusion criteria were strict, and the studies were assessed for risk of bias using the RoB 2 and JBI Critical Appraisal Tools. Results Of the 13 selected studies, Axicabtagene Ciloleucel showed a response rate of 78%, while Tisagenlecleucel reached 52%. Both treatments presented adverse effects, such as cytokine release syndrome and neurotoxicity, but these were manageable. Axicabtagene Ciloleucel demonstrated greater overall survival, progression-free survival, and better therapeutic adherence. Conclusions Both CAR-T therapies effectively treat refractory B-cell lymphoma, although Axicabtagene Ciloleucel showed better overall survival, progression-free survival, and improved therapeutic adherence.