Lisocabtagene maraleucel (liso-cel) was found to offer a favorable benefit–risk profile relative to mosunetuzumab as a third-line or later treatment for relapsed or refractory (R/R) follicular lymphoma (FL), according to an article published in Experimental Hematology & Oncology.
The authors, led by Loretta J. Nastoupil of Southwest Oncology in Durango, Colorado, conducted an unanchored matching-adjusted indirect comparison (MAIC) to estimate the relative treatment effects between the TRANSCEND FL and GO29781 studies after accounting for between-study differences, with the goal of comparing the efficacy and safety of liso-cel and mosunetuzumab for third-line or later treatment in patients with R/R FL.
For TRANSCEND FL, the leukapheresis set (N=114) was used for primary comparisons of the following efficacy endpoints: objective response rate (ORR), complete response (CR) rate, duration of response (DOR), and progression-free survival (PFS). The treated set (N= 107) was used for comparisons of the following safety endpoints: cytokine release syndrome (CRS), neurological events (NE), serious infections, and use of corticosteroids or tocilizumab for CRS. Sensitivity analyses were conducted for efficacy using the TRANSCEND FL treated efficacy set (N=101).
After adjustment, liso-cel was associated with higher ORR (OR=3.78, 95% CI, 1.48‒9.67]) and CR rate (OR=6.46, 95% CI, 2.85‒14.65), and improved DOR (HR=0.45, 95% CI, 0.26‒0.77) and PFS (HR=0.28, 95% CI, 0.16‒0.49) compared with mosunetuzumab. Results remained consistent across sensitivity analyses.
In terms of safety, liso-cel had a lower incidence of grade ≥ 3 CRS (OR=0.45, 95% CI 0.04‒5.13), grade 3‒4 serious infections (OR=0.35, 95% CI 0.12‒1.03), and corticosteroid use for CRS management (OR=0.14, 95% CI 0.03‒0.65); however, liso-cel exhibited higher incidence of any-grade CRS (OR=1.86, 95% CI 1.01‒3.43), any-grade NEs (OR=2.16, 95% CI 0.72‒6.44), and tocilizumab use for CRS management (OR=2.27, 95% CI 0.86‒5.99).
“After adjusting for important clinical prognostic and treatment-effect modifiers, liso-cel was found to offer a favorable benefit–risk profile relative to mosunetuzumab as a third line or later treatment for R/R FL,” the authors concluded.
Reference
Nastoupil LJ, Bonner A, Wang P, et al. Matching-adjusted indirect comparison of efficacy and safety of lisocabtagene maraleucel and mosunetuzumab for the treatment of third-line or later relapsed or refractory follicular lymphoma. Exp Hematol Oncol. 2025;14(1):30. 2025 2025. doi:10.1186/s40164-025-00610-1
