Study highlights the importance of infection prevention after CAR-T cell therapy

RESEARCH SUMMARY

Study highlights the importance of infection prevention after CAR-T cell therapy

Study Title: A systematic review and meta-analysis of nonrelapse mortality after CAR T cell therapy 

Publication: Nature Medicine

Dana-Farber Cancer Institute authors: David M. Cordas dos Santos, MD, Irene M. Ghobrial, MD, Jean-Baptiste Alberge, PhD

Summary: Researchers at Dana-Farber Cancer Institute, in collaboration with colleagues from Memorial Sloan Kettering Cancer Center in New York (Dr. Kai Rejeski) and the LMU Hospital in Munich, Germany (Dr. Tobias Tix), have found that infections were the main driver of non-relapse mortality in patients receiving chimeric antigen receptor (CAR) T cell therapy. The team analyzed reports from 7604 patients across 18 clinical trials and 28 real world studies. Infections accounted for half of all reported non-relapse related deaths. Other cancers were the second most common driver at 7.8%. Cardiovascular or respiratory events were third, at 7.3%. Side effects specific to CAR-T cell therapy, such as cytokine release syndrome and neurotoxicity, played a minor role. Importantly, the researchers found non-relapse mortality to be associated with the underlying disease entity and certain CAR T-cell products, even when accounting for key study features. 

Significance: Much attention has been paid to the risks associated with CAR-T cell therapy and managing CAR-T cell therapy specific side effects, such as cytokine release syndrome and neurotoxicity. This study reveals that infections play a critical role in non-relapse related death and suggests a pressing need for comprehensive, evidence-based guidelines that inform infection prevention and management after CAR-T cell therapy. 

Funding: The German Cancer Consortium, Deutsche Forschungsgemeinschaft (DFG, German Research Foundation), the Munich Clinician Scientist Program, the Bruno and Helene Jöster Foundation, the Bavarian Cancer Research Center, the National Institutes of Health/National Cancer Institute, and Arnold Ventures.

Contact:  Nicole Oliverio, nicole_oliverio@dfci.harvard.edu