CAR T-Cell Therapy Effective Without Toxicity Risk in Patients With Primary/Secondary CNS Lymphoma

Patients with primary central nervous system lymphoma (PCNSL) and secondary central nervous system lymphoma (SCNSL) are able to respond to chimeric antigen receptor (CAR) T-cell therapy without an increased risk of cytokine release syndrome or Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS).

These results, from a systematic review and meta-analysis conducted by University of Arizona Cancer Center investigators, were presented in a late-breaking poster at the Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR (2022 Tandem Meetings), held in Salt Lake City, Utah, and virtually April 23-26, 2022.¹

Patients with PCNSL and SCNSL have historically been excluded from most CAR T-cell clinical trials because of the potentially fatal toxicities that are associated with ICANS and CRS. But the new review and meta-analysis—conducted by Muhammad Husnain, MD; and Noureen Asghar, MD—found that, of the 113 patients included in the review, more than half (56.6%, 64 patients) achieved complete response and 8.9% (10 patients) achieved partial response.

A total of 17 studies met inclusion criteria for review, totaling 113 patients. Most were retrospective or prospective analyses of trials and/or institutional observational studies, and 6 were case studies. The CAR T-cell therapies used in the study were axicabtageneciloleucel, tisagenlecleucel, and lisocabtagene maraleucel.

Based on the findings, investigators recommend that patients with PCNSL and SCNSL be included in future clinical trials for CAR T-cell therapy.

“CAR T-cell therapy shows comparable efficacy in patients with primary and secondary CNS lymphoma as compared to patients who do not have CNS involvement,” said Husnain, who serves as assistant professor of medicine in the division of Hematology and Oncology at the University of Arizona Cancer Center. “The neurotoxicity and the CRS, which is…a concern…our study showed it’s comparable and it’s tolerable and manageable toxicity… There is an unmet need for these patients.”

Reference:

Husnain M, Asghar N. Chimeric antigen receptor T cell therapy is effective in primary/secondary CNS large B cell lymphoma: a systematic review and meta-analysis. Poster presented at: Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR; April 23-26, 2022; Salt Lake City, UT. Accessed April 21, 2022. https://tandem.confex.com/tandem/2022/meetingapp.cgi/Paper/20547