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The best explanation for why one second-line CAR-T trial failed when two succeeded is how long the cells took to make. That interval is almost never a reported endpoint.
This is a cheap idea with a large effect on interpretation. The cross-trial inference that manufacturing time explains BELINDA is the best available explanation for a 322-patient randomised failure, and it remains an inference because the data to test it were not collected as endpoints. Rapid-manufacture and point-of-care products are entering trials now, which makes the measurement urgent rather than retrospective.
ZUMA-7 rewrote second-line treatment for aggressive lymphoma: patients whose disease returns within a year of R-CHOP should be offered CAR-T rather than salvage chemotherapy and transplant. It is also one of the few cell-therapy trials to show an overall survival benefit despite crossover. Patients relapsing later than 12 months were not studied and transplant remains standard for them if chemosensitive.
The reason second-line CAR-T is offered with axicabtagene ciloleucel or lisocabtagene maraleucel rather than tisagenlecleucel. The trial is also the strongest evidence in the field that the interval between apheresis and infusion, and what is given during it, is part of the treatment rather than logistics around it.
The evidence that made lisocabtagene maraleucel the CD19 CAR-T product most often chosen for older or frailer patients, because its severe cytokine release syndrome rate is a fraction of the other two products'.
Shares Bridging therapy, Lymphodepletion before CAR-T, BELINDA, TRANSFORM and the tag lymphoma-evidence.
Shares Lymphodepletion before CAR-T, Axicabtagene ciloleucel, Manufacturing cost and time for living and radioactive medicines, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares The CAR-T pathway in lymphoma: referral, apheresis, bridging and the waiting, Tisagenlecleucel, Manufacturing cost and time for living and radioactive medicines, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting and the tag lymphoma-evidence.
Shares Tisagenlecleucel, Manufacturing cost and time for living and radioactive medicines, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting, Follicular lymphoma and the tag lymphoma-evidence.
Shares Axicabtagene ciloleucel, Weak real-world evidence and registries, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting, CAR-T cell therapy and the tag lymphoma-evidence.
Shares Trial design, endpoints and cost, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting, Follicular lymphoma, Diffuse large B-cell lymphoma and the tag lymphoma-evidence.
Shares Trial design, endpoints and cost, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting, Follicular lymphoma, Non-Hodgkin lymphoma (all types) and the tag lymphoma-evidence.
Shares Manufacturing cost and time for living and radioactive medicines, Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting, Follicular lymphoma, Non-Hodgkin lymphoma (all types) and the tag lymphoma-evidence.