ASH 2023: Using Inflammatory Biomarkers to Predict Response to CAR T-Cell Therapy

By: Jenna Carter, PhD
Posted: Monday, December 18, 2023

A retrospective study presented at the 2023 American Society for Hematology (ASH) Annual Meeting & Exposition (Abstract 92) highlighted whether looking at baseline values of inflammatory biomarkers may help to predict outcomes with chimeric antigen receptor (CAR) T-cell therapy in patients with multiple myeloma. Darren Denjay Pan, MD, of the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, and colleagues assessed the association between baseline labs and cytokine-release syndrome, immune effector cell–associated neurotoxicity syndrome, delayed neurotoxicity, and peak ferritin levels (≥ 5,000 ng/mL). Their findings revealed that cytokine-release syndrome occurred in 88.2% of patients; immune effector cell–associated neurotoxicity syndrome, in 15.7%; and delayed neurotoxicity, in 5.9%.

“CAR T-cell therapy is an effective tool for the treatment of multiple myeloma but produces a systemic inflammatory response, which can manifest as cytokine-release syndrome…immune effector cell–associated neurotoxicity syndrome…and other neurologic toxicities, and hyperferritinemia. Understanding the factors associated with these complications can help clinicians better evaluate their patients’ candidacy for CAR T-cell therapy,” stated Dr. Pan and colleagues.

A total of 101 patients with multiple myeloma treated with CAR T cells were included in this study. Patients received CAR T-cell therapy with either commercial products or on clinical trials at Mount Sinai Hospital between 2017 and 2023. Baseline inflammatory status was determined using lab parameters, which were then compared with maximum grade of cytokine-release syndrome and immune effector cell–associated neurotoxicity syndrome. Additional study outcomes included occurrence of delayed neurotoxicity, attainment of peak ferritin ≥ 5,000 ng/mL within 30 days of infusion, progression-free survival, and overall survival.

Increased baseline levels of fibrinogen and ferritin were significantly associated with inferior overall survival, even after covariate adjustments (P = .031 and .010, respectively). There was also a trend toward inferior overall survival (P = .055) in patients with higher baseline cytokine-release syndrome.

Disclosure: For full disclosures of the study authors, visit ash.confex.com.

2023 ASH Annual Meeting & Exposition

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