ASCO 2026 | Impact of mRNA SARS-CoV-2 vaccination on CAR T-cell therapy outcomes in hematologic malignancies
Jowan Al-Nusair, MD, Marshall University, Huntington, WV, discusses the impact of mRNA SARS-CoV-2 vaccination on CAR T-cell therapy outcomes in patients with hematologic malignancies, presenting findings from a multi-center real-world analysis that showed improved overall survival (OS) and lower risks of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in vaccinated patients. Dr Al-Nusair highlights the importance of these results, which suggest that mRNA SARS-CoV-2 vaccination may be beneficial for patients receiving CAR T-cell therapy, and notes that prospective studies are needed to further validate these findings and explore the optimal timing of vaccination. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
I had the opportunity to present my research just yesterday at ASCO 2026, and I also received the Bradley Stuart Beller Endowed Merit award for this project. So we wanted to examine the impact of mRNA SARS-CoV-2 vaccination on clinical outcomes in patients receiving CAR-T. We know that COVID-19 has been a leading cause of non-relapse mortality in this population, and there’s been a lot of hesitation about, you know, vaccinating these patients out of the concern that it may, for example, increase or exacerbate CAR-T-related inflammatory toxicities like CRS and ICANS...
I had the opportunity to present my research just yesterday at ASCO 2026, and I also received the Bradley Stuart Beller Endowed Merit award for this project. So we wanted to examine the impact of mRNA SARS-CoV-2 vaccination on clinical outcomes in patients receiving CAR-T. We know that COVID-19 has been a leading cause of non-relapse mortality in this population, and there’s been a lot of hesitation about, you know, vaccinating these patients out of the concern that it may, for example, increase or exacerbate CAR-T-related inflammatory toxicities like CRS and ICANS. So, and on top of that, we do have evidence that mRNA vaccinations can promote like type 1 interferon signaling and CD8-positive T-cell priming beyond their role in just infection prevention. So that’s kind of the main rationale for our study.
And we did this retrospective propensity score matched real-world cohort study, and we looked at peritreatment mRNA vaccination within basically six months of CAR-T cell therapy. And interestingly, we found improved overall survival in the vaccinated cohort. So patients who were vaccinated within six months basically had a 40% lower hazard of death within the two-year follow-up period. And not only that, but they also had significantly lower risks of CRS and ICANS. We also performed a separate analysis on bispecific T-cell engager recipients, and that survival benefit was actually consistent. The toxicity profile did diverge, but that could also reflect fundamental differences in the pharmacology of these therapies. And I think that our results are very reassuring, they’re practice-informing. And we would definitely suggest that prospective studies look more into also like pre-infusion versus, you know, post-infusion vaccination. And we would need prospective validation, of course.
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