# TRANSFORM

Source: https://onco.cc/trials/transform/  
OnCo record `transform` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The second trial to show a CAR-T beats transplant in early-relapsing large B-cell lymphoma.

## Summary

TRANSFORM, trial NCT03575351 sponsored by Bristol Myers Squibb and reported in 2022, was the second trial to show that a CAR-T beats salvage chemotherapy and autologous transplant in primary refractory or early-relapsed large B-cell lymphoma. It randomised 184 transplant-eligible patients to lisocabtagene maraleucel or standard care, met its primary event-free survival endpoint with a large effect and a much higher complete response rate, and was the basis of liso-cel's second-line approval in June 2022, although crossover to liso-cel confounded overall survival. OnCo links it to lymphoma, CAR-T, CD19 as a target, the pairing of CAR-T before transplant at early relapse and the ZUMA-7 and TRANSFORM papers, and the result is concordant with ZUMA-7. Whether the two approved second-line CAR-Ts differ meaningfully in efficacy or toxicity is the open question.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT03575351
- Phase: 3
- Setting: Primary refractory or early-relapsed LBCL, transplant-eligible: liso-cel vs salvage + autologous transplant
- Sponsor: BMS
- Enrolled: 184
- Result: EFS HR 0.36; CR 74% vs 43%.
- Outcomes: Event-free survival (median): Liso-cel 29.5 months vs Standard care 2.4 months, HR 0.36
- Replication: Concordant with ZUMA-7.

## Sources

- ClinicalTrials.gov NCT03575351: https://clinicaltrials.gov/study/NCT03575351

## Connected records

- roadmaps: [Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting](https://onco.cc/roadmaps/lymphoma-roadmap/)
- trials: [BELINDA](https://onco.cc/trials/belinda/), [JULIET](https://onco.cc/trials/juliet/), [TRANSCEND NHL 001](https://onco.cc/trials/transcend-nhl-001/)
- ideas: [Report the time from apheresis to infusion as a trial endpoint, not a logistics footnote](https://onco.cc/ideas/lymphoma-ev-manufacturing-time-as-a-trial-endpoint/)
- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Primary mediastinal (thymic) large B-cell lymphoma](https://onco.cc/cancers/primary-mediastinal-b-cell-lymphoma/)
- technologies: [CAR-T cell therapy](https://onco.cc/technologies/car-t/)
- targets: [CD19](https://onco.cc/targets/cd19/)
- pairings: [Early relapse: CAR-T before transplant](https://onco.cc/pairings/car-t-before-transplant-lbcl/)
- terms: [Autologous stem cell transplant (ASCT)](https://onco.cc/terms/autologous-transplant/), [Cytokine release syndrome and ICANS: grading and management](https://onco.cc/terms/lymphoma-tx-crs-icans/), [Lymphoma treatments that did not work: the negative trials worth knowing](https://onco.cc/terms/lymphoma-tx-failed-and-negative/), [Salvage therapy](https://onco.cc/terms/salvage-therapy/), [Stem cell transplant in lymphoma: what it is still for](https://onco.cc/terms/lymphoma-tx-transplant-role/), [The CAR-T pathway in lymphoma: referral, apheresis, bridging and the waiting](https://onco.cc/terms/lymphoma-tx-car-t-pathway/), [Transplant or CAR-T at second line in diffuse large B-cell lymphoma](https://onco.cc/terms/lymphoma-decision-transplant-or-car-t/)
- key papers: [Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study](https://onco.cc/key-papers/paper-transcend-nhl-001-liso-cel-lancet-2020/), [Second-line tisagenlecleucel or standard care in aggressive B-cell lymphoma](https://onco.cc/key-papers/paper-belinda-tisagenlecleucel-second-line-nejm-2022/), [TRANSFORM: liso-cel CAR-T versus salvage chemotherapy and transplant in early-relapsing large B-cell lymphoma](https://onco.cc/key-papers/paper-transform-liso-cel-lancet-2022/), [ZUMA-7: axi-cel CAR-T instead of salvage chemotherapy and transplant for large B-cell lymphoma that relapses early](https://onco.cc/key-papers/paper-zuma-7-axi-cel-second-line-nejm-2022/)

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