New three-year follow-up results from the TRANSCEND FL trial show that patients with relapsed or refractory follicular lymphoma can achieve durable, multi-year remission with chimaeric antigen receptor (CAR) T cell therapy, even after prior treatments have failed, according to researchers at The University of Texas MD Anderson Cancer Centre.

The trial findings with lisocabtagene maraleucel (liso-cel) were presented today by Sairah Ahmed, M.D., associate professor of Lymphoma & Myeloma, at the 67th American Society of Haematology (ASH) Annual Meeting and Exposition (Abstract 467).

“We are seeing unprecedented response rates and durable remissions in patients whose follicular lymphoma had previously resisted multiple therapies,” said Ahmed, the trial’s principal investigator.

“These three-year results highlight not only the long-lasting benefit of CAR T cell therapy, but also its favourable safety profile, offering real hope for patients facing this challenging disease. MD Anderson is a participating site of the TRANSCEND trial.

What is the TRANSCEND FL trial and what are the key findings?

Follicular lymphoma is a B-cell malignancy characterised by slow progression but a high likelihood of disease recurrence.

Each relapse becomes more challenging to treat, while remission periods get shorter.

The multicenter TRANSCEND FL evaluated whether a single infusion of liso-cel, a type of CAR T cell therapy, could produce durable remissions and favourable safety profiles in patients whose follicular lymphoma had relapsed or was refractory after multiple prior therapies.

In 107 heavily pretreated patients, liso-cel produced remarkably high response rates, with 97% of patients responding to treatment and 94% achieving complete remission.

After three years of follow-up, most patients remained in remission.

Median duration of response, progression-free survival and overall survival had not yet been reached at a median follow-up of 41.5 months, demonstrating few patients had experienced relapse or disease progression, an encouraging sign that the therapy’s benefit is ongoing.

What was the safety profile of liso-cel for patients with follicular lymphoma?

The long-term safety profile of liso-cel remained consistent and manageable.

Severe cytokine release syndrome, a common side effect of CAR T cell therapy, occurred in 1% of patients, while severe neurological events occurred in 2% of patients.

These are relatively low rates compared to other CAR T cell therapies.

Although some patients developed infections or reduced blood counts over time, these effects were anticipated, and no new or unexpected safety issues emerged during the extended follow-up.

How do these results affect patients with follicular lymphoma?

The Food and Drug Administration’s accelerated approval of liso-cel in May 2024 allows this therapy to be used for certain patients with follicular lymphoma, providing a new option for individuals who previously had few effective treatments available.

This study is important because it offers three years of follow-up data, one of the longest reported for CAR T cell therapy in follicular lymphoma.

These results support the potential for using cell therapies earlier in the treatment course for certain patients.

Source: University of Texas M. D. Anderson Cancer Center