Relapsed Follicular Lymphoma CAR-T — RACP Adult Medicine MCQ
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Correct answer: D — CAR T-cell therapy (axicabtagene ciloleucel or tisagenlecleucel)
For multiply relapsed/refractory follicular lymphoma (after ≥2 prior lines of therapy), anti-CD19 CAR T-cell therapy (axicabtagene ciloleucel – approved based on ZUMA-5 trial; tisagenlecleucel – based on ELARA trial) is now available and offers durable responses in 60–80% of patients. It is TGA-approved and PBS-listed in Australia for this indication. Lenalidomide + rituximab (AUGMENT trial) and PI3K inhibitors are alternatives. Bispecific antibodies (mosunetuzumab – LOTIS-2 trial) are also emerging as effective options. Allogeneic SCT offers potential cure but carries significant transplant-related mortality.
Reference: eTG – 2025 – Haematology; PBS – 2025 – CAR T-cell Therapy Listings