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Opinion|Videos|April 8, 2026

Debate Round 2: Choosing a 2L CAR-T Product

Author(s)Megan Melody, MD, Matthew Cortese, MD, MPH, Marco Davila, MD, PhD

The panel debates how real-world differences in efficacy, vein-to-vein time, manufacturing reliability, and toxicity should influence selection between the two second-line CAR T options for early relapsed/refractory LBCL. One side argues that efficacy is broadly similar and that lower all-grade CRS/neurotoxicity, especially for outpatient delivery, favors the less toxic product, whereas the other emphasizes faster manufacturing, longer follow-up experience, and the importance of overall survival data in driving decisions. The discussion converges on individualized selection based on the patient in front of you (disease tempo, fitness, logistics, and center capacity), while acknowledging the lack of head-to-head randomized comparisons.

Episodes in this series

7 experts are featured in this series.

EP. 1 Treatment Selection in Biologically Aggressive DLBCL

7 experts are featured in this series.

EP. 2 Real-World CAR-T Comparisons: Axi-cel vs Liso-cel in 2L LBCL

7 experts are featured in this series.

EP. 3 US Registry: Comparing Second-Line CAR-T Products in LBCL

7 experts are featured in this series.

EP. 4 Debate Round 1: Should CAR-T Be Given Inpatient or Outpatient?

7 experts are featured in this series.

EP. 5 Debate Round 2: Choosing a 2L CAR-T Product

The panel debates how real-world differences in efficacy, vein-to-vein time, manufacturing reliability, and toxicity should influence selection between the two second-line CAR T options for early relapsed/refractory LBCL. One side argues that efficacy is broadly similar and that lower all-grade CRS/neurotoxicity, especially for outpatient delivery, favors the less toxic product, whereas the other emphasizes faster manufacturing, longer follow-up experience, and the importance of overall survival data in driving decisions. The discussion converges on individualized selection based on the patient in front of you (disease tempo, fitness, logistics, and center capacity), while acknowledging the lack of head-to-head randomized comparisons.

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