AAN 2018—Neurological symptoms develop in almost half of patients receiving CAR T therapy for cancer


  • Univadis
  • Conference Reports
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Takeaway

  • Innovative cancer treatment may include troublesome and dangerous neurological symptoms.

Why this matters

  • Chimeric antigen receptor T-cell (CAR T) therapy carries considerable benefits for patients with certain cancers, but the treatment also comes with serious neurological risks.

Key results

  • About 41% of patients undergoing CAR T therapy developed neurological symptoms within 2 weeks of receiving infusions.
  • The clinical spectrum of neurotoxicity may include delirium, encephalopathy, aphasia, seizure and seizure-like activity, tremor/myoclonus, hallucinations, and diffuse cerebral edema.

Study design

  • 53 adult patients with b-acute lymphoblastic leukemia received lymphodepleting chemotherapy followed by CAR T cells as part of a single-institution phase 1 clinical trial.
  • The cells were removed from the patients, expanded and engineered in the laboratory to target cancer cells, and then infused back into the patient.

Limitations

  • Single-institution study.
  • No control group.

Expert comment

  • "There are risks to this therapy, but CAR T cell therapy is given to patients who have no other options. This adds to what we can do for patients. We are still learning how to best manage patients. Patients who are getting CAR T cells are expected to stay in the hospital about 14 days, so we are able to take care of any problems like this that arise." Felipe Samaniego, MD, associate professor of medicine, University of Texas MD Anderson Cancer Center, Houston, who was not involved in the study.

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