ZUMA-5: Curative potential of axi-cel in follicular lymphoma

Axicabtagene ciloleucel (axi-cel) was associated with durable responses and long-term survival in patients with relapsed or refractory indolent non-Hodgkin lymphoma. The 5-year outcomes of the phase 2 ZUMA-5 study were consistent with the 4-year outcomes, indicating that axi-cel is a highly effective, durable option in this population.

The phase 2 ZUMA-5 trial included 159 patients with indolent non-Hodgkin lymphoma who had received at least 2 prior lines of therapy [1]. Participants with follicular lymphoma (n=127) or marginal zone lymphoma (n=31) were exposed to the CAR T-cell therapy axi-cel. Prof. Sattva Neelapu (MD Anderson Cancer Center, TX, USA) presented the findings after 5 years of follow-up [2].

The overall response rate (ORR) was 90%, and the complete response rate was 75%. “These rates were even slightly higher in participants with follicular lymphoma, at 94% and 79%, respectively,” added Prof. Neelapu. The median duration of response was 60.4 months, and the median progression-free survival (PFS) was 62.2 months. Prof. Neelapu highlighted that the lymphoma-specific PFS was excellent, with only 2 participants showing progressive disease beyond 30 months post-leukapheresis. Moreover, the median overall survival was still not reached, and the rate of lymphoma-specific death was 15.6% in those with follicular lymphoma. Finally, there were no new drug-related safety issues.

“Axi-cel continues to demonstrate durable responses among these patients with follicular or marginal zone lymphoma,” concluded Prof. Neelapu. “This data supports that axi-cel is an efficacious approach for this population and has curative potential in patients with follicular lymphoma.”

  1. Jacobson CA, et al. Lancet Oncol. 2022;23(1):91-103.
  2. Neelapu SS, et al. 5-year follow-up analysis from ZUMA-5: a phase 2 trial of axicabtagene ciloleucel (axi-cel) in patients with relapsed/refractory indolent non-Hodgkin lymphoma. Abstract 864, 66th ASH Annual Meeting, 7–10 December 2024, San Diego, CA, USA.
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