Visual abstract | DALY 2-EU primary analysis: Zamto-cel in 2L transplant-ineligible patients with R/R LBCL

CD19-targeted chimeric antigen receptor (CAR) T-cell therapies have substantially improved outcomes in patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL); however, relapse post CAR T-cell therapy remains a clinical challenge.¹ Antigen escape through loss of CD19 expression is one key mechanism of relapse.¹ CAR T-cell therapies dual targeting both CD19 and CD20 may be effective in overcoming resistance and improving outcomes.^1,2

Zamtocabtagene autoleucel (zamto-cel) is a tandem CD20-CD19-directed non-cryopreserved CAR T-cell therapy (Figure 1) that can be administered as a fresh product.³ Zamto-cel is manufactured using an automated, closed-system platform that integrates the key steps of the CAR T-cell manufacturing process, with a reported apheresis-to-infusion time of 13–15 days (Figure 2).^3,4 

Part 1 of the phase II DALY 2-EU trial (NCT04844866) compared zamto-cel vs standard of care (rituximab + gemcitabine + oxaliplatin [R-GemOx] or polatuzumab vedotin + bendamustine + rituximab [Pola-BR]) in patients with second-line (2L) relapsed/refractory (R/R) large B-cell lymphoma (LBCL) who are ineligible for autologous stem cell transplantation.³ Primary results from the DALY 2-EU trial comparing zamto-cel vs R-GemOx were presented by Peter Borchmann at the 67th American Society of Hematology (ASH) Annual Meeting and Exposition, December 6–9, 2025, Orlando, US, and are summarized below.³

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