Real-world outcomes and toxicities of CAR-T in relapsed/refractory follicular lymphoma: a multicenter cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT: Chimeric antigen receptor T-cell therapy has revolutionized the treatment of relapsed/refractory (R/R) follicular lymphoma (FL). Real-world efficacy and toxicity data are needed because clinical trial populations are often unrepresentative. Therefore, we conducted a multicenter retrospective study of R/R FL patients undergoing commercial axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) between 2021 and 2024. End points included efficacy measures (overall response rate [ORR], complete response rate [CRR], progression-free survival [PFS], and overall survival [OS]) and toxicity (rates of cytokine release syndrome [CRS] and immune effector cell-associated neurotoxicity syndrome [ICANS]). Among 136 patients, 100 (74%) received axi-cel and 36 (26%) received tisa-cel. Axi-cel patients were younger than tisa-cel patients (median age, 60 vs 68 years; P = .001) and received bendamustine lymphodepletion less often than them (9% vs 33%; P< .001). Median follow-up was 14.4 months (range, 0.8-72.0 months). In the unweighted analysis, compared with tisa-cel, axi-cel was associated with higher ORR (96% vs 80%; P = .007), CRR (88% vs 71%; P = .024), and longer median PFS (30.5 months vs 11.9 months; P = .021). Median OS did not differ significantly between the 2 products (not reached vs 23.6 months; P = .061). The rates of CRS were comparable (75% vs 75%; P = .99), whereas ICANS occurred more frequently with axi-cel than with tisa-cel (42% vs 17%; P = .008). After inverse probability of treatment weighting, efficacy outcomes were largely similar, but axi-cel remained associated with significantly higher toxicity. In real-world settings, both axi-cel and tisa-cel demonstrated efficacy in patients with R/R FL, although PFS was inferior to that reported in clinical trials.
Source: Blood Advances
Authors: John Sharp, Paolo Strati, Subodh Bhatta, Jennifer J. Huang, Colin Thomas, Omar Elghawy, Daniel Reef, Alexander Gorzewski, John Wang, Geoffrey Shouse, Catherine Reinert, Andinet Teferra, Esteban Toro Velez, Ari Pelcovits, Thomas Ollila, William Clark, Victor Yazbeck, Joseph Maakaron, Manali Kamdar, Lindsey Fitzgerald, Alexey Danilov, Reem Karmali, Natalie S. Grover, Stefan K. Barta, Timothy J. Voorhees, Andy I. Chen, Mazyar Shadman, Sairah Ahmed, Narendranath Epperla
Institutions: The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, The University of Texas MD Anderson Cancer Center, University of Washington, Fred Hutch Cancer Center, University of Pennsylvania, University of North Carolina at Chapel Hill, UNC Lineberger Comprehensive Cancer Center, Northwestern University, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, City Of Hope National Medical Center, City of Hope, University of Colorado Cancer Center, University of Minnesota, Masonic Cancer Center, Virginia Commonwealth University, Brown University, University of Utah, Huntsman Cancer Institute, Oregon Health & Science University
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,800
OpenAlex ID: W7131664346