ASH 2024 | Key predictors of success when administering CAR-T for DLBCL

So when we think about the patients who are getting CAR T-cell therapy for treatment of diffuse large B-cell lymphoma, there are some things we can use to predict the likelihood that they have toxicity or the opportunity for a durable response. One of the predictors that I use in my clinic is just the disease burden. How much disease does that patient have on imaging, particularly on PET scan? In our research endeavors, we look at metabolic tumor volume, but it’s often not measured in our patients. So I just kind of have an idea, and patients who have large tumors with lymphoma that’s over five centimeters, I often send them for radiation bridging after we’ve collected. Other factors that I use in my practice include measurements of inflammation. We recently published a paper in Blood Cancer Discovery where we created a scoring system for these markers of inflammation. IL-6 is the cytokine that we often look at and think about, but it’s not clinically available. So we look at CRP and ferritin, and by measuring these values prior to CAR-T treatment, we can actually predict the patients who are most likely to progress quickly after CAR T-cell therapy and similarly, most likely to have toxicities. And so again, CRP, ferritin, if those are elevated, that’s a poor prognostic factor. And then of course, the more prior lines of therapy patients have, the less likely they are to respond to CAR-T. And so the sooner they’re referred to get treatment, the better.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.