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SOHO 2026 | Deciding between bispecifics and CAR-T in R/R follicular lymphoma
Krish Patel, MD, Sarah Cannon Research Institute, Nashville, TN, discusses deciding between bispecific antibodies and CAR T-cell therapy for patients with relapsed/refractory follicular lymphoma (R/R FL). Dr Patel notes that CD19 CAR-T has shown impressive five-year follow-up data, while for patients who cannot access CAR-T, bispecific antibodies also offer a valuable option. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
Yeah, so in follicular lymphoma and the third line setting and beyond, we have the opportunity to choose either bispecific antibody-based therapy, either in combinations now or as a single agent, or CD19 CAR T-cells. And I think this is really one of the most challenging decisions to help guide a patient through. We’ve seen now from several of the CAR-T trials, five-year follow-up data with really, really impressive plateau in progression-free survival, maybe around just under 50% of patients maintaining that remission more than five years from their CAR T-cell therapy...
Yeah, so in follicular lymphoma and the third line setting and beyond, we have the opportunity to choose either bispecific antibody-based therapy, either in combinations now or as a single agent, or CD19 CAR T-cells. And I think this is really one of the most challenging decisions to help guide a patient through. We’ve seen now from several of the CAR-T trials, five-year follow-up data with really, really impressive plateau in progression-free survival, maybe around just under 50% of patients maintaining that remission more than five years from their CAR T-cell therapy. In a late-line follicular lymphoma setting, that might equate to a curative outcome. So I think that’s really important to have as part of the conversation with patients. On the flip side, not everybody will be able to access that therapy. And so this is often where partnerships with community oncologists to try to understand, do patients have the interest and ability to travel potentially to receive a therapy like that? And if they don’t, I think, you know, bispecific antibodies are a really phenomenal tool in that setting as well. Monotherapy outcomes look very good in that setting, but also now we have combination data with lenalidomide, if patients have not received that earlier, that can show really, really high complete response rates and very, very impressive progression-free survival, at least out to two years, which is where we have the data.
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