Comparative survival and time toxicity outcomes of CAR-T versus bispecific antibody therapies in relapsed/refractory FL
Year: 2026
Type: article
Study design: Observational Study
Abstract: Chimeric antigen receptor T-cell (CAR-T) and CD20xCD3 bispecific antibody (BsAb) therapies are both effective for relapsed/refractory (R/R) follicular lymphoma (FL), but comparative real-world survival outcomes and time toxicity have not been characterized. We performed a multicenter retrospective study of 228 patients with R/R FL treated with standard-of-care CAR-T (n = 141) or BsAb (n = 87) across 17 U.S. academic centers in the third-line or later setting. Progression-free survival (PFS) and overall survival (OS) were stratified by 2 or ≥3 prior lines of therapy (LOT2 or LOT3+), including propensity matching. Time toxicity was measured by physical health care contact days. Median PFS was not reached (NR) with CAR-T and 581 days with BsAb in the LOT2 cohort (p < .0001), and was NR with CAR-T and 584 days with BsAb in the LOT3+ cohort (p = .0064). CAR-T recipients were younger (p < .0001) and had better performance status (p = .007) but were more refractory to prior LOT (p = .017). PFS advantages of CAR-T were independent of these differences. OS did not differ between treatment groups. CAR-T had significantly greater time toxicity over the first year, with higher mean contact days than BsAb in both the LOT2 (58 vs 44) and LOT3+ (69 vs 49) cohorts. In this large multicenter cohort of patients with R/R FL, CAR-T was associated with superior PFS but greater time toxicity compared with BsAb therapy. These findings provide real-world outcomes data and time toxicity benchmarks to support treatment sequencing decision-making in R/R FL.
Source: Blood Advances
Authors: Ajay Major, Diana Abbott, Jordan Snyder, Nausheen Ahmed, Alline Nogueira Serodio, Jose Caetano Villasboas, John Sharp, Timothy J Voorhees, Samin Houshyar, Danielle S Wallace, Arjab Adhikari, Dilan Patel, Christopher Mwaniki Wanjiku, Charlotte B. Wagner, Allison M Bock, Taylor R Brooks, Haya Al Any, Mazie Tsang, Mohamed Rajab, Madiha Iqbal, Nidhi Desai, Supriya Gupta, Nicole Altomare, Reem Karmali, Daniel Trotier, Priyanka A. Pophali, Edd Ricker, Hua-Jay J. Cherng, Jessica A. Chicola, Pallawi Torka, Jennifer C. Keenan, Asaad Trabolsi, Jonathan H Schatz, Arjun Gupta, Brian T. Hill
Institutions: University of Colorado Anschutz, University of Colorado Denver, Colorado School of Public Health, University of Kansas, The University of Kansas Cancer Center, Cleveland Clinic Abu Dhabi, Mayo Clinic, Oregon Health & Science University, The Ohio State University, Ochsner Medical Center, University of Rochester Medicine, Washington University in St. Louis, UNC Lineberger Comprehensive Cancer Center, Huntsman Cancer Institute, Cleveland Clinic, Mayo Clinic Hospital, Mayo Clinic in Florida, University of Minnesota, Masonic Cancer Center, Northwestern University, University of Wisconsin–Madison, University of Wisconsin Carbone Cancer Center, Columbia University Irving Medical Center, Memorial Sloan Kettering Cancer Center, University of Miami, City Of Hope National Medical Center, City of Hope
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: W7224918088