Antioch culturally not stand out. If Alexander does not rise above, then ... just for me this city is very important, but the fate of Carthage is not so significant ...It seems difficult to imagine a world where Alexandria doesn't become at least a pretty impressive city on par with OTL Antioch.
(Incidentally, curious when the Diadochi will get in on that urban foundation game in this timeline. Syria and Mesopotamia could use some more Greek settlements. maybe an Amyntasia on the Orontes?)