ArticleEuropean journal of haematology2026
Real-World Experience With a ZUMA-1 Cohort 4 Adopted Approach to CRS and ICANS in CAR-T Recipients.
Article in European journal of haematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Real-World Experience With a ZUMA-1 Cohort 4 Adopted Approach to CRS and ICANS in CAR-T Recipients.European journal of haematology · 2026Article
- The Conflicting Role of Myeloid Cells in CAR T-Cell Therapy.Cancer research · 2026Review
- Early steroid and anakinra use to manage axicabtagene ciloleucel toxicity reduces the total duration of CRS and ICANS.Blood advances · 2026Article
- The current socioeconomic and regulatory landscape of immune effector cell therapies.Frontiers in medicine · 2024Review
Corrections and comments
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Axicabtagene ciloleucel (Axi-cel) is a chimeric antigen receptor T-cell (CAR-T) therapy approved for the treatment of relapsed/refractory (R/R) large B-cell lymphoma (LBCL). The registrational phase 1/2 ZUMA-1 study cohorts 1 and 4 addressed toxicity management in terms of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) whereby tocilizumab and corticosteroids were deployed earlier in cohort 4. In this real-world, single-institution study of 119 patients receiving Axi-cel CAR-T therapy for R/R LBCL with 70 in cohort 1 and 49 in cohort 4, we demonstrate significantly less toxicity, intensive care unit (ICU) utilization, and cumulative steroid use with an early intervention strategy. Laboratory parameters and comorbidities did not significantly differ between groups except for a higher incidence of renal insufficiency in the cohort 4 group (28.6% vs. 4.3%, p < 0.01). The maximum grade CRS was significantly lower for cohort 4 versus 1 (1 vs. 2, p < 0.01). Furthermore, cumulative corticosteroid use was significantly less in the cohort 4 early intervention group (110 mg vs. 190 mg dexamethasone equivalents). These favorable findings did not have a deleterious impact on outcomes and efficacy with similar overall response rate, progression-free survival, and overall survival with both toxicity management approaches.
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