Nat Med: Characteristics of CAR-T cell therapy for patients with large B-cell lymphoma.

Oct 7, 2020 /--- -- Researchers at the University of Texas MD Anderson Cancer Center have identified molecular and cellular characteristics associated with CD19 CAR T cell therapy, which are associated with the reaction of patients with large B-cell lymphoma (LBCL) after treatment and whether side effects occur.
(Photo: www.pixabay.com) also found that early changes in the DNA of circulating tumors a week after CAR T cell therapy may indicate a therapeutic response in a particular patient.
the paper was published in the journal Nature Medicine.
, associate professor and co-author of the study, said: "CAR T cell therapy is very effective for LBCL.
, however, we face two major clinical challenges: achieving long-term mitigation and managing treatment-related adverse events.
" study suggests that clinicians may be able to identify some patients who may have worse outcomes or adverse treatment reactions during the first week of treatment.
this will allow the nursing team to adjust the treatment to improve efficacy or reduce toxicity.
the study, the researchers performed a single-cell analysis of CAR T cells to study gene expression spectrum in injected cells.
car T cells from the remaining cells in the infusion bag after treating 24 LBCL patients.
these gene maps with the therapeutic response determined by PET/CT scans three months after infusion.
when we looked at the characteristics of the injected CAR T cells, we found that T cells in samples of patients who responded less to treatment were depleted, and T cells in patients who recovered fully expressed 'memory' signals,"
said.
" co-author Satva Neelapu, M.D., Professor of Lymphoma and Myeloma, said: "Furthermore, T-cell failure is more common in patients with poor performance, and poor molecular responses are usually associated with lower positive long-term results.
, the researchers analyzed the patient's early molecular response by monitoring changes in circulating tumor DNA within a week of treatment to infusion.
changes in tumor-related DNA corresponded to the response, indicating that patients who showed early molecular response were more likely to have a clinical response to treatment.
side effects of CAR T cell therapy may include cytokine release syndrome and neurotoxic syndrome (ICANS) associated with immune-effect cells.
these adverse events can delay patient recovery and may lead to increased demand for hospitalization and intensive care.
"We found that CAR-T cells have myelin-like cell characteristics, and cell groups with monocyte-like transcription characteristics are associated with the development of high neurotoxicity.
testing these cells may then allow us to identify patients at higher risk of neurotoxicity, allowing us to provide preventive treatment for specific cellular characteristics.
(bioon.com) Source: tudy identifies features of the infused CAR T cells in patients with large B-cell lymphoma Original source: Deng, Q., Han, G., Puebla-Osorio, N. et al. Features of anti-CD19 CAR T cell infusion products associated with efficacy and toxicity in patients with large B cell lymphomas. Nat Med (2020). doi.org/10.1038/s41591-020-1061-7,