CAR-T for follicular lymphoma: are we good to go?

In this issue of Blood, Ghione et al(1) have compared outcomes for patients with multiply relapsed follicular lymphoma treated with axicabtagene ciloleucel (axi-cel) in the ZUMA-5 study with those in the retrospective SCHOLAR-5 registry. Axi-cel was highly active in the ZUMA-5 population, with an impressive complete response rate of 79% and the median progression free survival not yet reached after 17.5 months of follow-up.(2) However, as a single-arm study, it is not possible to directly compare these outcomes with the plethora of currently available therapies, including various combinations of chemotherapy, anti-CD20 and bispecific antibodies, lenalidomide, phosphoinositide 3-kinase inhibitors, or enhancer of zeste homolog (EZH) 2 inhibitors. In the comparative effectiveness study, Ghione et al used propensity-scoring analysis on prespeci-fied prognostic factors using standardized mortality weighting to match patients in the SCHOLAR-5 registry to those in the study. The authors charted marked improvements in response rate with axi-cel, as well as a notably improved time to next treatment and improved progression-free and overall survival, with a substantial 58% reduction in the risk of death (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.21-0.83).

Automated summary

In this study, the effectiveness of axicabtagene ciloleucel in treating patients with multiply relapsed follicular lymphoma was compared. The results showed that axicabtagene ciloleucel had excellent efficacy, with prolonged progression-free survival and significantly improved overall survival.