Translating ZUMA-1 Trial Data for Axi-Cel CAR T in 3L Treatment Decisions

CAR T-cell therapy has shifted the landscape of treatment for relapsed or refractory large B-cell lymphoma, offering hope not only for prolonged remission but, in some cases, a potential cure. While oncologists often avoid using the word cure, long-term follow-up data now support its use for a subset of patients. Results from studies such as the 5-year follow-up of pivotal trials demonstrate a durable response in approximately 35% of patients, suggesting true disease eradication in those individuals.

This long-term durability was a critical question early in the development of CAR T-cell therapy. While initial remission rates were promising, there was uncertainty around how long responses would last and when it would be safe to say that relapse was unlikely. With extended follow-up data now available, physicians can more confidently reassure patients who remain disease-free for several years that their risk of recurrence is significantly diminished, allowing them to focus on recovery and life beyond treatment.

Equally important are the long-term safety outcomes. For a treatment to be truly transformative, it must not only prolong survival but also preserve quality of life. The extended data show that most patients eventually regain healthy immune function, with recovery of B cells and stable blood counts in the majority. Importantly, the risk of serious late effects such as secondary malignancies appears no higher than with other intensive treatments such as autologous stem cell transplant. This balance of efficacy and manageable long-term toxicity strengthens the role of CAR T-cell therapy as a frontline option in the third-line setting and beyond, reinforcing its value in the evolving standard of care