Early relapse: CAR-T before transplant
If large B-cell lymphoma comes back within a year, CAR-T should come before, not after, a transplant attempt.
ZUMA-7 and TRANSFORM: CAR-T beats salvage chemotherapy plus transplant on EFS, and ZUMA-7 on OS; transplant remains for late relapses that respond to salvage.
TRANSFORM confirmed ZUMA-7's conclusion with a different CD19 CAR-T and a more permissive design that allowed bridging chemotherapy, making the results closer to real-world practice. Liso-cel's low toxicity makes it attractive for older or frailer patients and for outpatient delivery. Together the two trials made CAR-T the standard second-line therapy for early-relapsing aggressive lymphoma.
ZUMA-7 rewrote second-line treatment for aggressive lymphoma: patients whose disease returns within a year of R-CHOP should be offered CAR-T rather than salvage chemotherapy and transplant. It is also one of the few cell-therapy trials to show an overall survival benefit despite crossover. Patients relapsing later than 12 months were not studied and transplant remains standard for them if chemosensitive.
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not linked directly; found by shared links- PersonFrederick L. Locke
Shares ZUMA-7, ZUMA-7: axi-cel CAR-T instead of salvage chemotherapy and transplant for large B-cell lymphoma that relapses early, Diffuse large B-cell lymphoma, CAR-T cell therapy.
- Key paperJULIET: tisagenlecleucel for adults with relapsed or refractory diffuse large B-cell lymphoma
Shares BELINDA, Diffuse large B-cell lymphoma, CAR-T cell therapy.
- TermAutologous stem cell transplant (ASCT)
Shares TRANSFORM, ZUMA-7, Diffuse large B-cell lymphoma.
- Key paperZUMA-1: axicabtagene ciloleucel for refractory large B-cell lymphoma, the first CAR-T approved for lymphoma
Shares ZUMA-7, ZUMA-7: axi-cel CAR-T instead of salvage chemotherapy and transplant for large B-cell lymphoma that relapses early, Diffuse large B-cell lymphoma, CAR-T cell therapy.
- TermSalvage therapy
- ProductLisocabtagene maraleucel
Shares TRANSFORM: liso-cel CAR-T versus salvage chemotherapy and transplant in early-relapsing large B-cell lymphoma, Diffuse large B-cell lymphoma, CAR-T cell therapy.
- ProductAxicabtagene ciloleucel
Shares ZUMA-7, ZUMA-7: axi-cel CAR-T instead of salvage chemotherapy and transplant for large B-cell lymphoma that relapses early, Diffuse large B-cell lymphoma, CAR-T cell therapy.
- IdeaCollect and freeze T cells at diagnosis for high-risk patients, before chemotherapy