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Ahead of the 2026 Transplantation & Cellular Therapy Meetings, experts preview data on CAR T-cell therapy efficacy, donor access, and toxicity mitigation.
As the
Bhagirathbhai Dholaria, MD, MBBS, FACP, an associate professor of medicine in the Department of Medicine in the Division of Hematology Oncology at Vanderbilt University Medical Center in Nashville, Tennessee, highlighted several abstracts that have the potential to meaningfully inform practice. Among them is the first US experience with BCMA-directed CAR T-cell therapy in patients with relapsed/refractory light chain (AL) amyloidosis from the phase 1/2 NEXICART-2 trial (NCT06097832).1 Early safety and efficacy signals with this investigational agent, including rapid, deep hematologic responses and high rates of minimal residual disease (MRD) negativity with a favorable toxicity profile, were also presented at the
From an access and equity perspective, Sairah Ahmed, MD, an associate professor in the Department of Lymphoma/Myeloma in the Division of Cancer Medicine and director of the CART Program at The University of Texas MD Anderson Cancer Center in Houston, emphasized emerging work focused on social drivers of health in transplant and cellular therapy. She highlighted a novel needs assessment and patient navigation program designed to improve access to bone marrow transplant and cellular therapies, noting that although longer-term outcomes data are needed, these efforts represent an important step toward addressing structural barriers that limit equitable delivery of advanced therapies. Ahmed also underscored abstracts examining modifiable risk factors associated with delayed neurotoxicity and non-relapse mortality following CAR T-cell therapy, with the goal of refining patient selection and improving safety.2
In the lymphoma field, Tycel Phillips, MD, an associate professor in the Division of Lymphoma at City of Hope in Duarte, California, identified real-world CAR T-cell therapy datasets as a key area of interest. He highlighted a consortium analysis comparing lisocabtagene maraleucel (liso-cel; Breyanzi) and axicabtagene ciloleucel (axi-cel; Yescarta) in the second-line setting for relapsed/refractory large B-cell lymphoma (LBCL), noting that real-world effectiveness and safety data may help clarify ongoing debates around optimal product selection outside of clinical trials. Phillips also pointed to emerging data on CAR T-cell therapy in chronic lymphocytic leukemia (CLL), where historically limited use and higher toxicity have constrained adoption.
Key Abstracts to Watch at the 2026 Transplantation & Cellular Therapy Meetings
Dholaria: Options for relapsed AL amyloidosis are limited. Deep, rapid hematological response is key for preserving organ function. In this trial, a single infusion of NXC-201, an autologous BCMA-targeting CAR T-cell therapy, [generated] rapid hematological responses with MRD negativity in [most] patients.2 The treatment was well tolerated with low-grade cytokine release syndrome and no immune effector cell–associated neurotoxicity syndrome.
Dholaria: The phase 2 ACCESS trial (NCT04904588) prospectively evaluated post-transplant cyclophosphamide–based graft-vs-host disease prophylaxis in patients undergoing mismatched unrelated donor peripheral blood stem cell transplant. In this abstract, comparable 1-year outcomes were seen between 4-6/8 vs 7/8 mismatched unrelated donor transplants. The trial enrolled [mostly] nonHispanic white patients who often face challenges with finding a matched donor. These results greatly expand the potential donor pool for such patients.
Ahmed:[This is an] important study to improve access to cell therapy and transplant. Future studies [are] needed to address how this affects [patients’] ability to receive therapy and [downstream] outcomes, but [it is] a good start.
[Another abstract in this session focuses on] potentially modifiable risk factors, such as absolute lymphocyte count and nonresponse to bridging [therapy], to [help] choose which [patients] will [have the best outcomes] with ciltacabtagene autoleucel [Carvykti].
[Additionally, investigators are] potentially using a blood test to predict response to CAR T-cell therapy. Pretreatment plasma cell-free RNA reflects the tumor microenvironment in LBCL and can predict response to anti-CD19 CAR T-cell therapy.
Phillips: There’s a real-world analysis of [liso-cel] vs [axi-cel] in patients with [relapsed/refractory] LBCL. This will be a good evaluation of safety differences or efficacy differences between these 2 CAR T-cell therapies. These are the only 2 we have approved in [the] second-line setting. There’s been a bit of debate over which one is most appropriate for patients. In this patient population, liso-cel has some generalizability, whereas axi-cel is only for younger patients. It will be interesting to see if there are any updates and to figure out whether there are any outcome differences in this consortium paper to say that one is better than the other, at least in the real-world setting.
Phillips: Historically, CAR T-cell therapy for CLL has only been for a subset of patients, so [it will] be good to see in this presentation [the] selectivity of the patients they chose, [and the] outcomes of patients in general. [CAR T-cell therapy has] almost has been looked at as a boom-or-bust–type treatment, where it either works well for a small subset of patients, [or] it doesn’t work at all. A concern is also with the toxicity, which is much higher than what we see with liso-cel [in any] other disease setting. I’m curious to see what this real-world [analysis evaluates] and whether there are better outcomes and characteristics [than] what we saw in the pivotal clinical trial [leading to the 2024
