Transcend NHL Study: Promising Long-Term Results for CAR T-Cell Therapy in Large B-Cell Lymphoma

Chimeric Antigen Receptor T-cell (CAR T) therapy is an innovative form of immunotherapy that turns a patient’s own immune cells into precisely targeted cancer fighters.

Scientists collect a patient’s T cells — white blood cells that normally help defend against infection — and genetically engineer them in the laboratory to express a synthetic “chimeric” receptor. This receptor acts like a homing device, allowing the modified T cells to recognize a specific marker (antigen) on the surface of cancer cells. Once these reprogrammed cells are infused back into the bloodstream, they can seek out, bind to, and destroy tumor cells far more effectively than unmodified immune cells.

The new research looked into a specific type of CAR T-cell therapy called lisocabtagene maraleucel (often shortened to liso-cel), which is sold under the brand name Breyanzi.

Liso-cel works in the following ways (the three B’s):

• Borrow: The first step is to borrow or extract your white blood cells (T cells) through blood collection. This process is called apheresis, in which blood is collected, part of the blood is taken out (in this case, white blood cells), and the rest is returned to you.
• Boost: Then your white blood cells (T cells) are given a boost with the addition of a receptor called a CAR. That’s how they become your Breyanzi CAR T cells.
• Benefit: Finally, the CAR T cells are infused back into your body so that you may benefit from their enhanced cancer-targeting abilities.

Long Term Follow-Up

The TRANSCEND NHL study included adults with relapsed or refractory LBCL who had already undergone two or more lines of previous treatments. Patients participating in this study received liso-cel after confirming active lymphoma through imaging tests.

“My colleague and first author Jeremy Abramson on behalf of all of us co-authors, presented the five year survival results in the large B-cell lymphoma cohort of the Transcend NHL study. The net is that this is a highly efficacious treatment,” Dr. Kamdar explains.

“Median overall survival was 27.5 months. The estimated overall survival rate at five years was 38%. The median disease-free survival was 68 months and the estimated disease-free survival rate at five years was 52%,” she adds.

This data support the curative potential of liso-cel, Dr. Kamdar says, adding “It was extremely important to also underline that there were very few deaths because of progression after two years after having received CAR T-cell infusion.”

The long-term outcomes of this groundbreaking study are promising.

• After five years, about 38% of patients treated with liso-cel were still alive. Importantly, those who achieved a complete remission — meaning no detectable cancer after treatment — had an even better outlook, with approximately 56% alive at the five-year mark.
• Additionally, when looking specifically at survival rates directly related to lymphoma progression, more than half (52%) were alive five years after receiving the treatment.
• Another critical finding is that most patients who survived beyond two years after CAR T-cell infusion had a significantly better chance of long-term survival, highlighting the importance of this initial milestone. The median overall survival for all treated patients was approximately 27 months.

What About Side Effects?

Dr. Kamdar explains that there were no new safety concerns using this treatment approach.

The most common serious side effects after initial treatment were low blood counts (such as anemia or neutropenia), which typically resolved within a month. Serious infections occurred in a small percentage of patients, underscoring the importance of continued monitoring and supportive care.

The data show the following encouraging results:

• No new safety signals (nothing unexpected emerged between years 2 and 5)
• Blood counts recover for most
• Serious anemia, neutropenia, or low platelets after day 90 occurred in roughly one quarter of patients and typically resolved within a month
• Only 6% had severe infections after the three-month mark, though vigilance remains important
• Three deaths from infection were recorded, two in patients who had also received further cancer therapy
• Second cancers were rare — 8% developed another malignancy, most often non-melanoma skin cancer or myelodysplastic syndrome (these rates are similar to heavily pretreated lymphoma populations)

What do these results mean for you?

That 38% five-year survival rate matters because in earlier eras of LBCL treatment, only a small fraction of patients survived even two years once the disease returned. The fact that nearly four in ten liso-cel recipients are still alive five years later — and more than half of those who achieved a complete remission — suggests the therapy can offer durable control and, for some, a potential cure.

Patients whose scans turn completely negative after liso-cel have a better than 50-50 chance of being alive at five years.

If you are well at the 24-month visit, the odds tilt strongly in your favor. Safety is manageable long-term. While monitoring continues, very few late side-effects appeared, and no new patterns of harm cropped up.

Whether your center offers liso-cel, axi-cel, or another product, survival curves are approaching each other — good news for patients everywhere.

Roughly one in four patients did not see enough shrinkage to be called a response. Clinical trials of next-generation or “dual-target” CAR T cells, bispecific antibodies, and novel drugs remain crucial for those individuals.

Questions To Ask Your Doctor

• Will my insurance cover CAR T therapy?
• How long will I need to stay in the hospital?
• Can I work or travel afterward?
• Whats are the risks vs. benefits of this approach

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