Caroline Diorio, MD, FRCPC, FAAP, on Noninflammatory Neurotoxicity Events in Patients Receiving CAR-T
The attending physician at the Cancer Center at Children's Hospital of Philadelphia discussed a study she coauthored that was recently published in Blood.
“...[CAR T-cells] come with a set of side effects that we don't have the same level of experience that we do with chemotherapy that's been around for 50, 60, or 70 years. I think we need to bring our attention to the toxicities associated with CAR-T with the same rigor that we approach understanding curative therapies.”
In recent years, chimeric antigen receptor T-cell (CAR-T) therapy has provided a transformative new treatment option for patients with hematologic malignancies. In some cases, CAR-T therapy is able to achieve responses in patients who relapsed or were refractory to more traditional cancer treatments, such as chemotherapy. Despite this advantage, CAR-T is not without its own drawbacks, especially when it comes to unique safety concerns. One of the most prominent safety concerns associated with CAR-T therapy is its tendency to produce neurotoxicity, with immune effector cell-associated neurotoxicity syndrome (ICANS) constituting a particular concern of this type. As of yet, research aimed at gaining a better understanding of the pathophysiology of adverse events associated with CAR-T is still ongoing. One such study, “Quadriparesis and paraparesis following chimeric antigen receptor T-cell therapy in children and adolescents” was recently published in Blood. The study looked at a small group of children who experienced quadriparesis or paraparesis ICANS phenomena following treatment with CAR-T. Notably, the investigators found that the ICANS was not associated with inflammation, in contrast to expectations.
Following the study’s publication, CGTLive® reached out to first author Caroline Diorio, MD, FRCPC, FAAP, an attending physician at the Cancer Center at Children's Hospital of Philadelphia, to learn more. Diorio gave some background context regarding the study and went over the key findings. Afterwards, she discussed bigger picture implications of these findings, emphasizing that cases of neurotoxicity following CAR-T need to be considered uniquely based on their phenotypes, as they may have different underlying pathophysiology.
