CAR T-Cell Therapies Show Superior Survival Outcomes Compared to Real-World Salvage Treatments for R/R Follicular Lymphoma

Compared to standard immunochemotherapy, CAR T-cell therapies including axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), and lisocabtagene maraleucel (liso-cel), demonstrate improved survival outcomes for South Korean patients with relapsed/refractory (R/R) follicular lymphoma (FL), according to results published in Cancer Research and Treatment.

Previous research has found axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel efficacious for the treatment of R/R FL, however research is limited on their effects compared to traditional salvage therapies. Researchers conducted an indirect comparative analysis using data from the ZUMA-5, ELARA, and TRANSCEND FL trials to compare real-world efficacy of CAR-T therapies against standard immunochemotherapy using data from the Samsung Medical Center – Lymphoma Cohort Study (SMC-LCS).

 A control arm was comprised of 49 patients from SMC-LCS were included with 121 treatment episodes. Among patients treated with axicabtagene ciloleucel, tisagenlecleucel (tisa-cel), and lisocabtagene maraleucel, the median overall survival (OS) was not reached. After MAIC weighting, all 3 CAR T products demonstrated a substantial survival benefit over standard-of-care salvage regimens. 

Adjusted hazard ratios (aHRs) for OS among treated patients were 0.37 (95% confidence interval [CI], 0.21 to 0.64) for axicabtagene ciloleucel, 0.24 (95% CI, 0.11 to 0.53) for tisagenlecleucel, and 0.38 (95% CI, 0.13 to 1.04) for lisocabtagene maraleucel. As for aHRs for progression-free survival (PFS), they were 0.35 (95% CI, 0.20 to 0.59) for axicabtagene ciloleucel, 0.35 (95% CI, 0.20 to 0.60) for tisagenlecleucel, and 0.36 (95% CI, 0.15 to 0.88) for lisocabtagene maraleucel. 

These findings confirm that axi-cel, tisa-cel, and liso-cel each deliver meaningful clinical benefits in R/R FL, with hazard ratios favoring CAR T-cell therapy over standard salvage options for both OS and PFS.

The researchers concluded, “Notably, all [3] CAR-T therapies demonstrated comparable effectiveness against conventional therapy when adjusted for baseline characteristics.”

“The similar hazard ratios observed for OS and PFS across axi-cel, tisa-cel, and liso-cel suggest that these therapies may offer similar clinical benefits,” they added. 

Source:

Seo HJ, Kim JH, Yoon SE, et al. Effectiveness of CAR-T Cell Therapies for Relapsed/Refractory Follicular Lymphoma: An External Control Arm Study. Cancer Research and Treatment. Published online September 17, 2025. doi:10.4143/crt.2024.1181