Neurological adverse events following CAR T-cell therapy: a real-world analysis

Immunotherapy. 2020 Oct;12(14):1077-1082. doi: 10.2217/imt-2020-0161. Epub 2020 Aug 18.

Abstract

Aim: To characterize real-world neurological adverse events (AEs) associated with chimeric antigen receptor T-cell therapies in patients with refractory/relapsed large B-cell lymphomas. Materials & methods: Postmarketing case reports from the US FDA AEs reporting system involving axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) for large B-cell lymphomas were analyzed. Results: Of 804 AE cases identified (637 axi-cel, 167 tisa-cel), 428 (67%) of axi-cel cases and 43 (26%) of tisa-cel cases reported neurological AEs. Compared with cases without neurological AEs, significant associations were observed between neurological AEs and use of axi-cel, age ≥65 years, and the outcome of hospitalization. Conclusion: Neurological AEs were common with chimeric antigen receptor T-cell therapy in the real world and largely reflected those reported in clinical trials.

Keywords: CAR T-cell therapy; adverse events; neurotoxicity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Biological Products / adverse effects*
  • Biological Products / therapeutic use
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / immunology
  • Male
  • Middle Aged
  • Nervous System Diseases / chemically induced*
  • Receptors, Antigen, T-Cell / therapeutic use*
  • Receptors, Chimeric Antigen / therapeutic use*
  • T-Lymphocytes / drug effects
  • Treatment Outcome
  • Young Adult

Substances

  • Antineoplastic Agents, Immunological
  • Biological Products
  • Receptors, Antigen, T-Cell
  • Receptors, Chimeric Antigen
  • tisagenlecleucel
  • axicabtagene ciloleucel