The 2022 Tandem Meetings | Efficacy & toxicity of CAR-T therapy in patients with secondary CNS involvement
Nirav Shah, MD, Medical College of Wisconsin, Milwaukee, WI, talks on the use of CAR-T therapy in patients with diffuse large B-cell lymphoma (DLBCL) with secondary central nervous system (CNS) involvement. A small cohort study has shown that these patients can achieve long-term survival with CAR-T therapy, with neurotoxicity and cytokine release syndrome (CRS) rates comparable to that of patients with no CNS involvement. This interview took place at the Transplantation & Cellular Therapy (TCT) Meetings of ASTCT™ and CIBMTR® 2022 in Salt Lake City, Utah.
Transcript (edited for clarity)
So, the clinical trials for CAR-T, as one would expect, did not allow patients with secondary CNS involvement. However, since it’s been approved, we have been able to give it sort of in an off-label fashion for those patients who had systemic and concurrent secondary CNS involvement. And so our group has treated several patients with refractory secondary CNS lymphoma, and while it didn’t work for everyone, we have now long-term survivors of that...
So, the clinical trials for CAR-T, as one would expect, did not allow patients with secondary CNS involvement. However, since it’s been approved, we have been able to give it sort of in an off-label fashion for those patients who had systemic and concurrent secondary CNS involvement. And so our group has treated several patients with refractory secondary CNS lymphoma, and while it didn’t work for everyone, we have now long-term survivors of that. And what we found is that, even though they have secondary CNS involvement, we didn’t see higher rates of CRS or, the larger concern, higher rates of ICANS or neurotoxicity. So, our dataset was small, it was about eight patients, but I think it provides some reassurance that you can give CAR-Ts to this patient population, and I look forward to groups actually studying that population in a more robust fashion in a prospective clinical trial.
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