QOL Improvements Noted After CAR T-Cell Therapy in LBCL

Improving the quality of life (QOL) experience for patients is paramount for clinicians. However, administering CAR T-cell therapy for large B-cell lymphoma comes with specific guidelines and restrictions that patients must adhere to, which can make living their day-to-day lives challenging.

Manali Kamdar, MD, spoke about how adjustments have been made to these restrictions, which allow for better QOL for patients receiving treatments like lisocabtagene maraleucel (liso-cel; Breyanzi).

Kamdar presented findings from a long-term follow-up study (NCT03435796) based on the phase 3 TRANSFORM trial (NCT03575351) at the 2025 American Society of Hematology (ASH) Annual Meeting and Exposition. Findings included a median overall survival that was not reached (NR), with a 48-month rate of 61.5% (95% CI, 51.2%-71.7%). Additionally, the median progression-free survival (PFS) in the second-line setting was NR (95% CI, 12.6-NR) for the liso-cel arm vs 6.2 months (95% CI, 4.3-8.6) in the standard of care arm. Of note, the 48-month PFS rate was 52.2% (95% CI, 41.5%-62.8%) vs not available between both arms, respectively.

Overall, Kamdar, a clinical director of Lymphoma Services at the University of Colorado Anschutz School of Medicine, gave a look into other ways clinicians are beginning to manage QOL, including prophylactic measures.

Transcript:

It’s very important to highlight a couple of new changes. First, previously, the FDA mandated that patients who received any CAR T-cell therapy be at the treatment site for about 30 days. That is no longer on the label. Now, we need to keep our patients for only the first 14 days after infusion. That is a huge win for patients, especially those who come from far [away], and for their QOL. Besides that, the driving restrictions have also been eliminated from 8 weeks to under 4 weeks now. That’s a huge plus. With regard to toxicity profiles on a long-term basis, [for liso-cel], like with any other CAR T-cell therapy product, there are 2 risks. One would be the small but real chance of cytopenias and the small but real chance of infection. It’s very important that for the first year, patients be on prophylactic antivirals; for the first 6 months, [they should receive] prophylactic antibiotics. Then, subsequently, [we] make sure that we check their immunoglobulin titers to make sure that if they are under the supratherapeutic at the subtherapeutic range, then we replete our patients with IVIG or intravenous immunoglobulin replacements.

Reference

Kamdar M, Solomon S, Arnason J, et al. Lisocabtagene maraleucel (liso-cel) versus standard of care (SOC) for second-line relapsed or refractory large B-cell lymphoma (LBCL): First Results from long-term follow-up of TRANSFORM. Blood. 2025;146(suppl 1):3710. doi.10.1182/blood-2025-3710