Dual-antigen targeting of large B-cell lymphoma shows promise in reducing relapse

MD Anderson Research News January 08, 2026

• Large B-cell lymphoma (LBCL) is an aggressive blood cancer with few treatment options

• CAR T cell therapy targeting CD19 can work for patients with LBCL, but many relapse due to loss of CD19 expression

• This Phase II trial explored a novel approach to target both CD19 and CD20 in LBCL treatment

• More than 70% of patients had a complete response  

Researchers from The University of Texas MD Anderson Cancer Center observed a reduction in relapses among patients with large B-cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel), a chimeric antigen receptor (CAR) T cell therapy targeting CD19, plus rituximab, an antibody that targets CD20. Findings from the Phase II clinical trial were published in Nature Cancer.

“Our study demonstrated the therapeutic benefit of targeting two antigens when treating large B-cell lymphoma,” said Paolo Strati, M.D., associate professor of Lymphoma, and the trial’s lead investigator. “The combination of axi-cel and rituximab produced deep and durable responses without introducing new safety concerns.”

What was the goal of this trial?

Large B-cell lymphoma is an aggressive blood cancer, and patients have limited treatment options. CAR T cell therapy works in LBCL by recognizing CD19, a protein on lymphoma cells. However, approximately 30% of patients relapse after CAR T cell therapy because the cancer cells stop expressing CD19.  

In this trial, researchers wanted to investigate whether targeting two antigens found in lymphoma cells would improve response rates and reduce relapses.

What were the trial’s key findings?

In this study, 26 patients with LBCL who no longer responded to chemotherapy received axi-cel and rituximab treatment intravenously. Researchers observed strong response rates, with 73% of participants having a complete response. The median duration of response was 26 months and, at data cutoff, 46% of patients were still responding to treatment. 

No new or unexpected safety issues were identified, and side-effects were manageable. 

How do these findings impact patient treatment? 

According to the results, patients with the best outcomes had higher levels of CAR T cells in their body and experienced higher exposure to rituximab. The addition of rituximab did not interfere with how axi-cel behaved in the body. 

The combination produced durable, long-lasting responses and may offer a new way to reduce relapse in patients with limited treatment options. This supports ongoing trials, where the ability to target both CD19 and CD20 is now integrated directly into the CAR T-cell product.

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The trial was funded by Kite. A full list of collaborating authors and their disclosures can be found with the paper.