axicabtagene ciloleucel + lisocabtagene maraleucel

**Axicabtagene ciloleucel + lisocabtagene maraleucel** is a combination of two autologous CD19-directed chimeric antigen receptor (CAR) T-cell therapies, axicabtagene ciloleucel (developed by Kite Pharma/Gilead) and lisocabtagene maraleucel (developed by Juno Therapeutics/Bristol Myers Squibb), both approved for relapsed/refractory large B-cell lymphomas. Axicabtagene ciloleucel uses a CD28 costimulatory domain for rapid T-cell activation and expansion, while lisocabtagene maraleucel employs a 4-1BB domain for potentially improved persistence and reduced toxicity; their combination is investigational to leverage complementary pharmacokinetics for enhanced efficacy in B-cell malignancies. Patient T cells are separately collected, genetically modified ex vivo to express anti-CD19 CARs, expanded, and infused intravenously after lymphodepleting chemotherapy, targeting CD19-positive malignant B cells while depleting normal B cells.