Chimeric antigen receptor T-cell therapy as a cure for large B-cell lymphoma

Large B-cell lymphoma (LBCL) is cured in most patients with first-line chemoimmunotherapy; however, 30%-40% of patients will have relapsed or refractory (R/R) disease. Of these patients, those with refractory or early relapsed LBCL may receive chimeric antigen receptor (CAR) T-cell therapy as their second-line treatment if they are eligible, and those with late relapse may instead receive high-dose chemotherapy with autologous stem cell transplantation, recently licensed second-line bispecific antibody with chemotherapy, other targeted agents, or palliative management only. This narrative review aims to summarize the data for CAR T-cell therapy as a curative-intent treatment for R/R LBCL based on available evidence. This evidence includes long‑term follow‑up data from the Phase 3 ZUMA‑7 and TRANSFORM trials, as well as other CAR T-cell therapy studies, which suggest the potential for CAR T‑cell therapy to achieve durable, possibly curative outcomes in R/R LBCL. Both studies show clear plateaus in Kaplan-Meier survival curves around 2 years, with sustained remissions extending to 5 years. These data offer a compelling perspective on the curative potential of CAR T-cell therapy while underscoring the need for continued follow‑up and broader analyses.