ArticleJournal for immunotherapy of cancer2021
Early toxicity and clinical outcomes after chimeric antigen receptor T-cell (CAR-T) therapy for lymphoma.
Article in Journal for immunotherapy of cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.
What it found
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Who cites it
43 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Cardiovascular Events After Chimeric Antigen Receptor T-Cell Therapy for Advanced Hematologic Malignant Neoplasms: A Meta-Analysis.JAMA network open · 2024Pooled it
- A systematic review and meta-analysis of nonrelapse mortality after CAR T cell therapy.Nature medicine · 2024Pooled it
- A meta-analysis to assess the risk of bleeding and thrombosis following chimeric antigen receptor T-cell therapy: Communication from the ISTH SSC Subcommittee on Hemostasis and Malignancy.Journal of thrombosis and haemostasis : JTH · 2024Pooled it
- Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis.Frontiers in oncology · 2022Pooled it
- COLAR: open-label clinical study of IL-6 blockade with tocilizumab for the treatment of immune checkpoint inhibitor-induced colitis and arthritis.Journal for immunotherapy of cancer · 2022Trial
- Chimeric antigen receptor T-cell therapy and cardiovascular outcomes in US Medicare beneficiaries.European heart journal · 2026Article
- Chimeric antigen receptor T cell therapy cardiotoxicity: a narrative review.Cardio-oncology (London, England) · 2026Review
- Healthcare resource utilization and costs in patients with multiple myeloma administered ciltacabtagene autoleucel in outpatient versus inpatient settings after one to three prior lines of therapy.Journal of comparative effectiveness research · 2026Observational
- Review
- Temporal trends, cardiovascular complications, and outcomes in patients receiving CAR T-cell therapy: a 6-year nationwide analysis.Cardio-oncology (London, England) · 2026Article
- Risk of Cardiovascular Disease Mortality in Patients With Diagnosed Cancer and Associated Genetic and Proteomic Mechanisms: A UK Biobank-Based Cohort Study.Journal of the American Heart Association · 2026Article
- Redefining cell therapy: CAR-engineered innate immune cells to conquer solid and hematologic malignancies.Molecular biology reports · 2026Review
- Physiological, patho-physiological, and potential therapeutic roles for neutrophils in cancer & beyond.Frontiers in immunology · 2026Review
- Prognostic implications of adverse events associated with CAR-T cell therapy: a population-based global observational study.EClinicalMedicine · 2025Article
- Acquisition of an immunosuppressive microenvironment after anti-CD19 CAR T-cell therapy is associated with T-cell dysfunction and resistance.Journal for immunotherapy of cancer · 2025Article
- Chimeric antigen receptor T-cell (CAR T-cell) and tumor-infiltrating lymphocytes (TILs) therapies in gastrointestinal malignancies: review of literature for clinical applications.Medical oncology (Northwood, London, England) · 2025Review
- Immunotherapy-Associated Cardiotoxicity: Current Insights and Future Directions for Precision Cardio-Oncology.Cancers · 2025Review
- Coordinating oncogenesis and immune evasion: KPNA2, GOLM1, and TK1 as novel CAR T-cell targets in lung adenocarcinoma.European journal of medical research · 2025Article
- Cardiovascular complications of cellular immunotherapies and associated risk factors.NPJ cardiovascular health · 2025Review
- Cardiotoxic Effects Following CAR-T Cell Therapy: A Literature Review.Current oncology reports · 2025Review
Corrections and comments
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Authors and funding
25 authors.
Funding
Abstract
backgroundChimeric antigen receptor T-cell (CAR-T) infusion is associated with early toxicity. Yet, whether early toxicity development holds ramifications for long-term outcomes is unknown.
methodsFrom a large cohort of consecutive adult patients treated with CAR-T therapies for relapsed or refractory lymphomas from 2016 to 2019, we assessed progression-free survival (PFS), by toxicity development (cytokine release syndrome (CRS), neurotoxicity, or cardiotoxicity]. We also assessed the relationship of toxicity development to objective disease response, and overall survival (OS). Multivariable regression was utilized to evaluate relationships between standard clinical and laboratory measures and disease outcomes. Differences in outcomes, by toxicity status, were also assessed via 30-day landmark analysis. Furthermore, we assessed the effects of early anti-CRS toxicity therapy use (at ≤grade 2 toxicity) on maximum toxicity grade observed, and long-term disease outcomes (PFS and OS).
resultsOverall, from 102 CAR-T-treated patients, 90 were identified as treated with single-agent therapy, of which 88.9% developed toxicity (80 CRS, 41 neurotoxicity, and 17 cardiotoxicity), including 28.9% with high-grade (≥3) events. The most common manifestations were hypotension at 96.6% and fever at 94.8%. Among patients with cardiac events, there was a non-significant trend toward a higher prevalence of concurrent or preceding high-grade (≥3) CRS. 50.0% required tocilizumab or corticosteroids. The median time to toxicity was 3 days; high grade CRS development was associated with cardiac and neurotoxicity. In multivariable regression, accounting for disease severity and traditional predictors of disease response, moderate (maximum grade 2) CRS development was associated with higher complete response at 1 year (HR: 2.34; p=0.07), and longer PFS (HR: 0.41; p=0.02, in landmark analysis), and OS (HR: 0.43; p=0.03). Among those with CRS, relative blood pressure (HR: 2.25; p=0.004), respectively, also associated with improved PFS. There was no difference in disease outcomes, or maximum toxicity grade (CRS, neurotoxicity, or cardiotoxicity) observed, based on the presence or absence of the use of early CRS-directed therapies.
conclusionsAmong adult lymphoma patients, moderate toxicity manifest as grade 2 CRS after CAR-T infusion may associate with favorable clinical outcomes. Further studies are needed to confirm these findings.
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