Meta-analysis of CAR-T and bispecific antibodies in follicular lymphoma: A comparative efficacy assessment.

Abstract

e19070 Background: Relapsed/refractory follicular lymphoma (RR-FL) presents significant treatment challenges due to its poor prognosis and limited effective therapies. Recent advancements have introduced chimeric antigen receptor T-cell (CAR-T) therapy and bispecific antibodies (BsAbs) as promising options. This meta-analysis aims to compare the efficacy of CAR-T therapy and BsAbs in RR-FL. Methods: We identified 443 records from Medline, Embase, Web of Science, and Cochrane databases. Out of these, 17 studies were included in the final analysis. 10 studies evaluated CAR-T therapy (59%), 7 studies reported BsAbs (41.17%). The primary outcome for the efficacy was expressed as pooled proportion of complete response rate (CRR), overall response rate (ORR), progression-free survival (PFS) at 12 months, and overall survival (OS) at 12 months. Results: The pooled proportion of CRR was 0.82 (95% CI [0.74, 0.88]) in the CAR-T group, compared to 0.64 (95% CI [0.55, 0.71]) in the BsAbs group. For ORR, the pooled proportion was 0.92 (95% CI [0.88, 0.95]) in the CAR-T group, versus 0.79 (95% CI [0.74, 0.82]) in the BsAbs group. At 1 year, the pooled proportion of OS was 0.95 (95% CI [0.92, 0.97]) for CAR-T, and 0.77 (95% CI [0.59, 0.89]) for BsAbs. The pooled proportion of PFS at 1 year was 0.75 (95% CI [0.65, 0.83]) for CAR-T, and 0.56 (95% CI [0.44, 0.67]) for BsAbs. Conclusions: CAR-T cell therapy demonstrated superior efficacy over BsAbs in treating RR-FL. These results suggest that CAR-T therapies may offer more durable and robust outcomes, making them a preferred treatment option for patients with RR-FL, though BsAbs remain a valuable alternative. Further real world studies are needed to assess the cost-benefit ratio and the safety profiles of both therapies.