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Daily Medical Update
Non-Hodgkin lymphoma
Wednesday, June 17, 2026
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🔬 Practice-Changing Findings
Evidence from RCTs and meta-analyses published in the
last 12 months.
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Blood cancer journal (2025) - Systematic Review
Key Findings
- CAR-T produced higher overall and complete response rates than bispecific antibodies in relapsed or refractory follicular lymphoma, with ORR 93% versus 82% and CRR 82% versus 67%.
- CAR-T improved progression-free survival at 6 months, 1 year, and 3 years, with rates of 85%, 74%, and 54% versus 74%, 62%, and 42% for bispecific antibodies; grade 3 or higher ICANS occurred in 8% versus 0%.
📋 Practice Implication: For fit patients needing third-line or later follicular lymphoma therapy, CAR-T has the strongest efficacy signal, but treatment selection still needs to account for the different neurotoxicity and infection tradeoffs.
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The Lancet. Haematology (2025) - Systematic Review
Key Findings
- Complete response was higher with CAR-T given after prior bispecific antibody exposure than with bispecific antibody monotherapy given after CAR-T, 53.7% versus 29.4%.
- Bispecific combination therapy after CAR-T outperformed bispecific monotherapy after CAR-T, and prior bispecific exposure was associated with improved objective response for subsequent CAR-T.
📋 Practice Implication: When both platforms are available for large B-cell lymphoma, these data support preserving CAR-T as an active later option and suggest that bispecific exposure does not preclude meaningful CAR-T benefit.
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Journal of cellular and molecular medicine (2025) - Systematic Review
Key Findings
- Consolidative radiotherapy after chemotherapy improved overall survival, progression-free survival, and event-free survival compared with chemotherapy alone in DLBCL.
- No survival benefit was seen in patients already in complete response after chemotherapy, whereas advanced IPI and advanced-stage subgroups showed improved outcomes with consolidative radiotherapy.
📋 Practice Implication: Post-chemotherapy radiotherapy should remain on the table for selected DLBCL patients with residual risk, but routine use after a documented complete response looks harder to justify.
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Haematologica (2025) - Systematic Review
Key Findings
- Among 538 adults with NHL receiving bridging radiation before commercial CD19 CAR-T, overall response to CAR-T was 78.9%, with 1-year progression-free survival 54.6% and overall survival 71.2%.
- Grade 3 or 4 CRS and ICANS rates were 3.6% and 10.6%, and sensitivity analyses did not show higher toxicity or worse efficacy with bridging radiation.
📋 Practice Implication: Radiation is a reasonable bridge for patients with symptomatic or bulky disease awaiting CAR-T manufacturing, especially when local control is needed without a clear penalty in downstream CAR-T outcomes.
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Academic radiology (2025) - Systematic Review
Key Findings
- Higher metabolic tumor volume was associated with worse progression-free survival and overall survival in follicular lymphoma, with hazard ratios of 2.91 and 4.30 respectively.
- Total lesion glycolysis showed stronger hazard ratios for progression-free and overall survival at 4.92 and 9.71, whereas SUVmax predicted progression-free survival with a hazard ratio of 2.14 but did not improve overall survival prediction.
📋 Practice Implication: Baseline PET burden metrics appear more clinically useful than SUVmax alone for follicular lymphoma risk stratification and may help identify patients who warrant closer follow-up or trial consideration.
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Summary
Recent Non-Hodgkin lymphoma evidence was led by treatment-sequencing and consolidation questions in follicular and large B-cell lymphoma, with CAR-T generally outperforming bispecific antibodies in later-line follicular lymphoma and retaining strong activity when used after prior bispecific exposure in large B-cell lymphoma. Two radiotherapy meta-analyses suggest radiation can still add value in selected DLBCL settings after chemotherapy and can bridge patients safely to CD19 CAR-T without clearly compromising efficacy. Risk stratification also advanced in follicular lymphoma, where PET-derived metabolic tumor burden measures showed strong associations with progression-free and overall survival.
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