Subsequent Malignancies After CD19-Targeted Chimeric Antigen Receptor T Cells in Patients With Lymphoma.

Area of Science:

• Oncology
• Immunotherapy
• Hematology

Background:

• Chimeric antigen receptor (CAR) T cell therapy is a successful treatment for B cell non-Hodgkin lymphomas (B-NHL).
• Understanding the long-term effects of CAR T cell therapy, including secondary cancers, is crucial given its increasing use.
• Late effects of CAR T cell therapy require further investigation to ensure patient safety.

Purpose of the Study:

• To determine the incidence of subsequent malignancies in adult patients with B-NHL treated with CAR T cells.
• To identify risk factors associated with the development of secondary cancers after CAR T cell therapy.
• To categorize the types of subsequent malignancies observed post-treatment.

Main Methods:

• Retrospective study of 355 adult patients with B-NHL treated with four different CAR T cell products.
• Data collected from two medical centers between 2016 and 2022.
• Analysis of cumulative incidence for subsequent malignancies at 36 months, categorized by cancer type.

Main Results:

• The overall cumulative incidence of subsequent malignancies at 36 months was 14%.
• Specific cumulative incidences at 36 months included solid tumors (6.1%), hematologic malignancies (4.5%), and dermatologic malignancies (4.2%).
• Increasing age was associated with a higher risk of subsequent malignancy; no T cell malignancies were observed.

Conclusions:

• While CAR T cell therapy offers significant survival benefits for B-NHL, a notable incidence of subsequent malignancies exists.
• Age is a risk factor for developing secondary cancers post-CAR T cell therapy.
• Further long-term studies are necessary to fully elucidate the risks, patterns, and underlying mechanisms of subsequent malignancies following CAR T cell therapy.