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ASH 2024 | An EASIX-based predictive model for CRS and ICANS after CAR-T therapy in RRMM
Jack Khouri, MD, Cleveland Clinic, Cleveland, OH, comments on the potential of the Endothelial Activation and Stress Index (EASIX) score to predict immune effector cell-associated neurotoxicity syndrome (ICANS) and cytokine release syndrome (CRS) after BCMA-directed CAR T-cell therapy for relapsed/refractory multiple myeloma (RRMM). Dr Khouri highlights that the EASIX score successfully predicted and could identify risk factors for CRS and ICANS, potentially serving as a basis for prospective studies on prophylactic treatments. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript
CAR T-cell therapy has some toxicities. So namely, you know, cytokine release syndrome and neurotoxicity or ICANS. And so the EASIX score is an endothelial dysfunction score that’s been validated in allogeneic stem cell transplant and predicts actually for complications from stem cell transplant. So we’re trying now to kind of look at this score, okay, in patients who receive CAR-T and see if this score can actually predict CRS and ICANS...
CAR T-cell therapy has some toxicities. So namely, you know, cytokine release syndrome and neurotoxicity or ICANS. And so the EASIX score is an endothelial dysfunction score that’s been validated in allogeneic stem cell transplant and predicts actually for complications from stem cell transplant. So we’re trying now to kind of look at this score, okay, in patients who receive CAR-T and see if this score can actually predict CRS and ICANS. The score was tested in lymphoma, in CAR T-cell therapy for lymphoma and ALL, so acute lymphoblastic leukemia, and actually it was found that it can actually predict CRS and ICANS. So we wanted to look at that in myeloma, patients who receive actually CAR T-cell therapy and see if the EASIX score actually can predict CRS and ICANS. So we looked at a cohort of I think 200 patients and we were able to show that the score can predict CRS and ICANS in myeloma patients receiving CAR T-cell therapy as well not just lymphoma and ALL. This is really important because we’re trying to figure out what the risk factors for CRS and ICANS are and you know this score can help us with that. Now, something else that we looked at was a novel score that we came up with in our patient cohort that can actually predict ICANS. This score actually incorporates EASIX and then along with the patient’s ECOG performance status and their cytogenetic abnormalities. So patients with a high risk score on EASIX and kind of, you know, a higher performance status and a higher risk cytogenetics, so patients with all three of those risk factors are the ones that actually have the highest risk of getting ICANS after CAR T-cell therapy. So this is really important because you can actually predict if your patient will have side effects from their CAR T-cell therapy. And this could serve as the basis for prospective studies in the future, looking at prophylactic treatments for prevention of CRS and ICANS.
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Disclosures
GPCR Therapeutics: Honoraria; Legend Biotech: Honoraria; Janssen: Consultancy; Janssen: Consultancy, Membership on an entity’s Board of Directors or advisory committees.
