Reduced pre-lymphodepletion ejection fraction and early post-infusion biomarker kinetics may be associated with increased all-cause mortality and cardiotoxicity events after CAR T cell therapy.
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Reduced pre-lymphodepletion ejection fraction and early post-infusion biomarker kinetics may help identify patients receiving CAR T cell therapy who are at increased risk for all-cause mortality and cardiotoxicity.
Background: Assessment of cardiovascular risk is critical for patients with cancer. Previous retrospective studies suggest potential cardiotoxicity of CAR T cell therapies. We aimed to prospectively assess cardiotoxicity and the predictive value of cardiac biomarkers and classical risk factors (age, cardiac function, diabetes, arterial hypertension, smoking) for cardiac events and all-cause mortality (ACM). Methods: In this prospective cohort study, all patients treated with CAR T cell constructs (axi-cel, tisa-cel, brexu-cel, ide-cel, or the 3rd generation CAR HD-CAR-1) from Oct 1, 2018, to Sept 30, 2022 at the University Hospital Heidelberg were included. Surveillance included cardiac assessment with biomarkers (high-sensitive Troponin T (hs-cTnT), N-terminal brain natriuretic peptide (NT-proBNP)), 12-lead-ECG, and 2D echocardiography. ACM was defined as the primary study endpoint, while cardiotoxicity, defined by clinical syndromes of heart failure or decline in ejection fraction, served as a secondary endpoint. Findings: ). None of the baseline characteristics was able to predict the incidence of cardiac events. Interpretation: Reduced pre-lymphodepletion ejection fraction and early post-infusion biomarker kinetics may be associated with increased ACM and cardiotoxicity events. These findings may help to identify patients who could benefit from intensified cardio-oncological surveillance. Funding: The German Center for Cardiovascular Research, German Research Foundation, and the Federal Ministry of Education and Research.
Korell et al. (Tue,) conducted a cohort in Cancer. CAR T cell therapy was evaluated on All-cause mortality. Reduced pre-lymphodepletion ejection fraction and early post-infusion biomarker kinetics may be associated with increased all-cause mortality and cardiotoxicity events after CAR T cell therapy.
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