Omar H. Butt, MD, PhD

“The next stage is trying to figure out where exactly is this injury coming from. And to do that, we actually have an ongoing prospective clinical trial that's combining all that we again have learned over the years from neurodegeneration to advanced neuroimaging, neurocognitive and neuropsychological testing, as well as a range of additional markers to distill down what exactly is the type of injury at each individual time over the course of treatment. So that's the next stage of our experiment.”

The risk of developing immune effector cell–associated neurotoxicity syndrome (ICANS) is associated with plasma neurofilament light chain (NfL) levels in patients treated with chimeric antigen receptor (CAR) T-cell therapy, according to a paper published in JAMA Oncology.

Authors and medical oncologists from Washington University School of Medicine in St. Louis Omar H. Butt, MD, PhD, and Alice Y. Zhou, MD, PhD,evaluated data from 30 patients with diffuse large B-cell lymphoma treated with CAR T-cell therapy in a retrospective, 2-center study. They found that patients who developed any grade ICANS had NfL elevations (mean, 87.6 pg/mL) prior to lymphodepletion and CAR T-cell infusion compared with those who did not develop ICANS (mean, 29.4 pg/mL; 

spoke with Butt and Zhou to learn more about the findings revealed in their study. What most surprised them is that people that developed ICANS had high NfL levels prior to treatment, in addition to concurrent with treatment.

Butt OH, Zhou AY, Caimi PF, et al. Assessment of pretreatment and posttreatment evolution of neurofilament light chain levels in patients who develop immune effector cell–associated neurotoxicity syndrome.

 Published online September 01, 2022. doi:10.1001/jamaoncol.2022.3738

Videos

The medical oncologists at Washington University School of Medicine in St. Louis discussed surprising findings from their retrospective study. 

Alice Zhou, MD, PhD, and Omar Butt, MD, PhD, on Surprising Associations With Neurotoxicity and Neurofilament Light 

“We still don't have that good of an idea of what's going on, especially with neurotoxicity... It's very important to sort of know that mechanism, where it's coming from, but also to identify the people who will develop neurotoxicity because at this point, we don't really know who's going to develop the severe side effects that can be fatal. It'd be nice to advise people who are getting this potentially lifesaving therapy,what is their likelihood of having issues or complications down the line.”

Patients treated with chimeric antigen receptor (CAR) T-cell therapy’s risk of developing immune effector cell–associated neurotoxicity syndrome (ICANS) is associated with plasma neurofilament light chain (NfL) levels, according to a paper published in JAMA Oncology.

First author Omar H. Butt, MD, PhD, and second author Alice Y. Zhou, MD, PhD, both medical oncologists at Washington University School of Medicine in St. Louis, evaluated data from 30 patients treated with CAR T-cell therapy for diffuse large B-cell lymphoma in a retrospective, 2-center study and found that patients who developed any grade ICANS had NfL elevations (mean, 87.6 pg/mL) prior to lymphodepletion and CAR T-cell infusion compared with those who did not develop ICANS (mean, 29.4 pg/mL; 

 spoke with Butt and Zhou to learn more about the unmet needs and issues that remain with toxicities in cell therapies with both ICANS and cytokine release syndrome among other toxicities. They discussed how studying the central nervous system of patients that developed toxicities led them to conduct the research.


Butt OH, Zhou AY, Caimi PF, et al. Assessment of pretreatment and posttreatment evolution of neurofilament light chain levels in patients who develop immune effector cell–associated neurotoxicity syndrome. 

The medical oncologists at Washington University School of Medicine in St. Louis discussed background to their research on associations between neurofilament light and neurotoxicity. 

Omar H. Butt, MD, PhD

Articles

Alice Zhou, MD, PhD, and Omar Butt, MD, PhD, on Surprising Associations With Neurotoxicity and Neurofilament Light

Alice Zhou, MD, PhD, and Omar Butt, MD, PhD, on Investigating Associations With CAR T Toxicities