Lisocabtagene Maraleucel Demonstrates Potential Improved Efficacy Over Mosunetuzumab for Third-Line or Later Treatment of R/R Follicular Lymphoma

For patients in the third-line or later (3L+) treatment of relapsed or refractory (R/R) follicular lymphoma (FL), lisocabtagene maraleucel (liso-cel) demonstrated improved efficacy and patient outcomes compared to mosunetuzumab, according to unanchored matching-adjusted indirect comparison (MAIC) results published in Experimental Hematology & Oncology.

No standard of care has been established for the treatment of FL after 2 lines of therapy, however, both lisocabtagene maraleucel and mosunetuzumab have been approved for patients with R/R FL as a third line of therapy in clinical trials. Researchers conducted an unanchored matching-adjusted indirect comparison utilizing patient-level data from the TRANSCEND FL study (NCT04245839) and data from the GO29781 trial (NCT02500407) to compare outcomes between therapies.

Following adjustment for balanced patient characteristics, patients treated with lisocabtagene maraleucel had a higher objective response rate (ORR, 94%; odds ratio [OR] = 3.78, 95% confidence interval [CI], 1.48 to 9.67 vs 80%; OR= 3.31; 95% CI, 1.37 to 8.03) and complete response (CR) rate (90.4%; OR = 6.46, 95% CI, 2.85 to 14.65), compared to patients treated with mosunetuzumab (60%; OR= 6.24; 95% CI, 2.95 to 12.23).

Additionally, treatment with lisocabtagene maraleucel demonstrated improved duration of response and a lower risk of disease progression (DOR, not reached; hazard ratio [HR] = 0.45, 95% CI, 0.26 to 0.77, compared with mosunetuzumab therapy (DOR, 22.8 months; 95% CI, 12.7 to not reached).) The median progression-free survival (PFS) for mosunetuzumab was 18 months (95% CI, 10.8 to not reached) and lisocabtagene maraleucel had not reached a median PFS (95% CI, 0.16 to 0.49).

In terms of safety, lisocabtagene maraleucel therapy had increased rates of any-grade cytokine release syndrome (CRS; OR = 1.86; 95% CI, 1.01 to 3.43), any-grade neurologic events (NEs; OR = 2.16; 95% CI, 0.72 to 6.44). In addition, lisocabtagene maraleucel was associated with a lower incidence of grade ≥3 cytokine release syndrome (CRS; OR = 0.45, 95% CI, 0.04 to 5.13), serious infections (OR = 0.35, 95% CI, 0.12 to 1.03), and corticosteroid use for CRS management (OR = 0.14, 95% CI, 0.03 to 0.65).

“In the absence of a prospective, randomized comparison, results from this MAIC of liso-cel with mosunetuzumab demonstrate better efficacy outcomes for patients with 3L+R/R FL treated with liso-cel, including improvements in ORR, CR rate, PFS, and DOR,” the researchers concluded.

Source:

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. Experimental Hematology & Oncology. Published online March 5, 2025. doi: 10.1186/s40164-025-00610-1