The Remarkable Success Of CAR T For Lymphoma 10 Years Later
Ten-year results show a single CAR T infusion can keep many patients with aggressive and slow-growing B-cell lymphomas cancer-free, pointing toward true long-term cures.
William A. Haseltine, Contributor
Forbes
3 min read
8/10
Key Takeaways
Of 101 patients with relapsed/refractory large B-cell lymphoma in the ZUMA-1 trial, 42% remained in complete remission at 10 years after a single infusion of axicabtagene ciloleucel (Yescarta).
For patients with follicular lymphoma treated with CAR T in separate long-term studies, 10-year overall survival exceeded 70%, with most survivors disease-free.
No late treatment-related deaths occurred beyond the first two years, addressing earlier concerns about secondary malignancies or prolonged immunosuppression.
The median time to relapse among those who eventually progressed was 4.9 months post-infusion, suggesting that if a patient remains cancer-free after one year, the risk of later relapse is very low.
The CAR T market earned $3.2 billion globally in 2025, with Yescarta accounting for $1.5 billion; Gilead and Novartis are now testing CAR T in earlier treatment lines for lymphoma.
Ten years after a single infusion, nearly half of patients with aggressive B-cell lymphoma remain cancer-free — a milestone that rewrites the rulebook on what 'cure' means. New data presented at the American Society of Clinical Oncology annual meeting and published in the New England Journal of Medicine this month shows that CAR T-cell therapy can deliver durable remissions for patients with both aggressive and indolent B-cell lymphomas, with many survivors marking a decade without relapse. The findings come from the longest follow-up yet of the first CAR T trials, specifically the ZUMA-1 study of axicabtagene ciloleucel (Yescarta), approved by the FDA in 2017 for relapsed or refractory large B-cell lymphoma. At the time, critics questioned whether the expensive, one-time treatment could truly offer long-term benefit. Now, 10-year data from 101 patients shows that 42% remain in complete remission. For those who respond fully in the first three months, the chance of staying cancer-free at ten years exceeds 60%. Among patients with follicular lymphoma, an indolent form of the disease, the remission rate is even higher, with over 70% alive and cancer-free at a decade. Importantly, no new safety signals emerged after the initial two years. Late effects, such as secondary cancers or organ damage, were rare. The results also undercut the need for maintenance therapy: many patients who received only the single infusion never required another cancer treatment. The longer-term data aligns with what CAR T-cell therapy advocates have long believed — that engineering a patient’s own immune cells to attack cancer can induce a functional cure for some blood cancers. Dr. William Haseltine, a former Harvard professor and author of the Forbes piece, called the results 'remarkable' and pointed toward 'true long-term cures.' But the science also faces economic and access barriers. A single CAR T infusion costs between $400,000 and $600,000 in the US, before hospitalisation and ancillary care. While Medicare now covers CAR T, many lower-income patients still lack access. The pharmaceutical companies behind the leading products — Gilead (Yescarta) and Novartis (Kymriah) — are exploring earlier lines of therapy and new manufacturing methods to lower costs. The next frontier is bringing CAR T to solid tumours, where it has struggled. But for lymphoma, the 10-year data is a clarion call. The question is no longer 'does CAR T work?' but 'how can we make it work for everyone?' The field is now watching whether similar long-term durability will emerge for other haematologic malignancies, such as multiple myeloma and acute lymphoblastic leukaemia. If so, the promise of a single-shot cure may be within reach for more patients in the next decade.
Frequently Asked Questions
CAR T-cell therapy is a personalised cancer treatment where a patient's own T cells are collected, genetically engineered to recognise and attack cancer cells, and then reinfused. It is currently approved for certain types of blood cancers such as B-cell lymphoma, acute lymphoblastic leukaemia, and multiple myeloma.
New 10-year data from the ZUMA-1 trial shows that 42% of patients with aggressive large B-cell lymphoma remain in complete remission a decade after a single infusion. For those who achieve a complete response within three months, the 10-year remission rate exceeds 60%.
Many researchers now consider CAR T therapy a potential cure for a subset of patients with B-cell lymphomas. The 10-year follow-up data shows durable remissions with no late relapses in those who remain cancer-free after the first year, meeting the clinical definition of cure for many individuals.
Common short-term side effects include cytokine release syndrome (fever, low blood pressure) and neurological toxicity (confusion, difficulty speaking). Long-term side effects from the 10-year data are rare, with no new safety signals after two years, though secondary cancers remain a rare concern.
A single CAR T infusion costs between $400,000 and $600,000 in the United States, not including hospitalisation, pre-treatment care, and follow-up. Total first-year costs can exceed $1 million. Medicare and some private insurers cover the therapy, but out-of-pocket costs can still be significant.
