Comparative survival and time toxicity outcomes of CAR-T versus bispecific antibody therapies in relapsed/refractory FL
In brief
CAR-T linked to longer lymphoma control but 14 to 20 more care days
In this 228-patient real-world study, median progression-free survival was not reached with CAR-T, versus about 19 months with bispecific antibodies, whether patients had two or at least three prior treatment lines. CAR-T involved 14 to 20 more health care contact days in the first year, while overall survival was similar; treatment choice still requires weighing disease control against time burden.
- Journal
- Blood advances (Q1)
- Published
- 30 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Ajay Major, Diana Abbott, Jordan Snyder, Nausheen Ahmed, Alline Nogueira Serodio, Jose Caetano Villasboas, et al.
- PMID
- 42962270
- DOI
- 10.1182/bloodadvances.2026020899
Why clinicians should know about it
- Picked for Hematology (paper of the day, 3 November 2026): Real-world comparison of CAR-T and bispecific therapy
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.