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Clinical determinants of survival outcomes and acute toxicity after adoptive cellular therapy for solid tumors
Jeong Uk Lim1,2, Derrick Tao3, Paul Nevins Selvadurai1
1Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Background:
The efficacy of cellular therapies has been demonstrated in hematologic malignancies, and their use is expanding to solid tumors. Predictors of outcomes and toxicities remain limited in patients undergoing cellular therapies for solid tumors.
Methods:
Data on patients with solid tumors who received cellular therapies between January 2016 and July 2025 in the Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program) at The University of Texas MD Anderson Cancer Center were reviewed retrospectively using the institutional CHIMERA database platform.
Results:
Among 122 patients, increased baseline C-reactive protein (CRP) was associated with shorter overall survival (OS) (hazard ratio [HR] 1.009, 95% confidence interval (CI) 1.005-1.013; P < 0.001), and higher log-transformed cell dose was associated with longer progression-free survival (PFS) (HR 0.636, 95% CI 0.476-0.850; P = 0.002). Among patients with baseline pulmonary function testing, zDLCO was associated with OS (HR 0.794, 95% CI 0.674-0.936; P = 0.006) and PFS (HR 0.826, 95% CI 0.696-0.979; P = 0.028). Cytokine release syndrome (CRS) occurred in 70 participants (57.4%). In the multivariate analysis, lower baseline absolute neutrophil count was associated with CRS of any grade (odds ratio [OR] 0.594, 95% CI 0.376-0.939; P = 0.026) and with CRS grade 2 or higher (OR 0.470, 95% CI 0.252-0.877; P = 0.018). Immune effector cell-associated neurotoxicity syndrome developed in 11 patients (9.0%).
Conclusions:
Baseline parameters such as CRP and pulmonary function may help identify patients at higher risk of adverse outcomes and toxicity during cellular therapy for solid tumors, and warrant prospective evaluation.
Insights
Cellular therapy shows promise for solid tumors, but predictors of outcomes are limited. Baseline C-reactive protein and pulmonary function may help identify patients at higher risk for adverse events.
Area of Science:
- Oncology
- Immunotherapy
Background:
- Cellular therapies are effective in hematologic cancers and are increasingly used for solid tumors.
- Predictors of outcomes and toxicities in solid tumor patients receiving cellular therapy are not well-defined.
Purpose of the Study:
- To identify predictors of outcomes and toxicities in patients with solid tumors undergoing cellular therapy.
Main Methods:
- Retrospective review of 122 patients with solid tumors who received cellular therapy between January 2016 and July 2025.
- Data analyzed from the institutional CHIMERA database platform.
Main Results:
- Increased baseline C-reactive protein (CRP) correlated with shorter overall survival (OS).
- Higher log-transformed cell dose was linked to longer progression-free survival (PFS).
- Pulmonary function (zDLCO) predicted both OS and PFS.
- Lower absolute neutrophil count was associated with higher rates of cytokine release syndrome (CRS).
Conclusions:
- Baseline CRP and pulmonary function may help identify patients at risk for adverse outcomes and toxicities.
- Prospective evaluation of these baseline parameters is warranted for optimizing cellular therapy in solid tumors.
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