EASIX Does Not Add Prognostic Value Beyond Lactate Dehydrogenase and ECOG Performance Status in CAR T-Cell Therapy: A...

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• The Endothelial Activation and Stress Index (EASIX) is a proposed predictor for endothelial complications in CAR T-cell therapy.
• Its prognostic value for long-term survival post-commercial anti-CD19 CAR T-cell therapy requires further evaluation.

Purpose of the Study:

• To assess the prognostic significance of EASIX for survival and toxicity in CAR T-cell therapy recipients.
• To compare EASIX performance against established clinical biomarkers like LDH and ECOG PS.

Main Methods:

• Retrospective multicenter study of 126 aggressive B-cell lymphoma patients treated with commercial CAR T-cell products.
• EASIX calculated pre-infusion (EASIX-d0); Cox models for OS/PFS; logistic regression for toxicity.
• ROC analysis compared EASIX-d0 vs. LDH; a combined LDH-ECOG PS model was also assessed.

Main Results:

• Higher EASIX-d0 associated with inferior overall survival (OS) and progression-free survival (PFS).
• EASIX-d0 predicted higher-grade ICANS but not CRS or nonrelapse mortality.
• EASIX-d0 predictive performance for OS/PFS was similar to LDH alone and inferior to a combined LDH-ECOG PS model.

Conclusions:

• EASIX-d0 is associated with survival and ICANS in CAR T-cell therapy, but its predictive power is influenced by LDH.
• Simpler, accessible markers like LDH and ECOG Performance Status offer comparable or superior prognostic value in real-world settings.