Roswell Park Researchers Develop Predictive Safety Score System for Lymphoma Patients Receiving CAR T-Cell Therapy

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Although CAR T-cell therapies have been found effective against certain difficult-to-treat malignancies, they are not devoid of safety concerns.

Researchers from Roswell Park Comprehensive Cancer Center in Buffalo, NY have developed a scoring system designed to identify patients with non-Hodgkin lymphoma who are more likely to have serious adverse events after receiving CAR T-cell therapy.

CAR T-cell therapy (short for chimeric antigen receptor T-cell therapy) uses T cells collected from a patient’s or donor’s blood to target and kill cancer cells. The T cells are modified in a laboratory to produce chimeric antigen receptors on their surfaces that recognize and attach to antigens on cancer cells. The altered T cells are infused back into the patient, where they target CD19 or B-cell maturation antigens on cancer cells.

Currently available CAR T-cell therapies are FDA-approved to treat various types of blood cancers, including B-cell acute leukemia (B-ALL), large B-cell lymphomas (LBCL), mantle cell lymphoma (MCL), follicular lymphoma (FL), multiple myeloma (MM), and chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL).

Although CAR T-cell therapies have been found effective against certain difficult-to-treat malignancies, they are not devoid of safety concerns. All approved therapies carry FDA boxed warnings for potentially life-threatening adverse effects, including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome (ICANS).

With a price tag of up to $475,000 per infusion, management of serious toxicities, if they occur, can easily bring the treatment costs to over $500,000.

Using their scoring system, the Roswell Park research team led by Megan Herr, Ph.D., associate professor of oncology in the department of medicine at the Transplant and Cellular Therapy section, found that non-Hodgkin lymphoma patients with worse physical function before receiving CAR T-cell therapy had a higher risk of developing ICANS and an increased one-year mortality risk.

“We developed a scoring system to predict which patients are most likely to develop serious side effects or adverse outcomes after receiving CAR T-cell therapy,” said Herr in a news release. “We think this richer insight into a patient’s functioning and prognosis might point the way to strategies for supporting our patients with non-Hodgkin lymphoma, with the goal of improving outcomes following CAR T-cell therapy,” she added.

Herr will present details from the research abstract on February 14, 2025, at the 2025 Tandem Meetings | Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR held February 12 through 15, 2025 at the Hawai’i Convention Center in Honolulu, HI. The abstract is titled "Physical Function Measures Identify Non-Hodgkin Lymphoma Patients at High Risk of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) and 1-Year Mortality After Chimeric Antigen Receptor T (CAR T) Cell Therapy”.

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