Liquid biopsy predicts neurotoxic complications of CAR-T cell therapy

Cell-based immunotherapy, known as CAR-T cell therapy, has revolutionized the treatment of several cancers

A simple blood test taken before CAR-T cell therapy begins may identify which patients are in the days or weeks after CAR-T cell therapy, according to a new study at Washington University School of Medicine in St.

The study, published Sept.

"Our study shows that some patients treated with CAR-T cells had undetected neuronal damage at baseline before we started preparing for this treatment," said lead author Omar H.

The NfL protein is a general marker of neuronal damage and has been used to measure or monitor the severity of several neurological diseases, including Alzheimer's disease and multiple sclerosis

"Measurement of NfL in blood is used as a method to assess the effectiveness of potential new treatments for multiple sclerosis," said co-corresponding author Professor Beau M.

The study was relatively small, involving 30 patients treated at Sitman Cancer Center and Case Comprehensive Cancer Center at Case Western Reserve University in Cleveland

Baseline levels of NfL distinguish those patients who do not experience neurotoxic side effects from those who experience any degree of such side effects

Complications vary from person to person and may include difficulty concentrating, memory problems, confusion, difficulty reading, headaches, and may also include seizures, stroke, and brain swelling

Another piece of the puzzle is that the rise in NfL levels is pre-existing and largely stable as some patients develop and recover from neurotoxic side effects

"We're only seeing the tip of the iceberg in terms of the actual disease process, and that's where a lot of our future research is going," Butt said.

Assessment of Pretreatment and Posttreatment Evolution of Neurofilament Light Chain Levels in Patients Who Develop Immune Effector Cell–Associated Neurotoxicity Syndrome