Clinical experience with cranial nerve palsy in patients infused with ciltacabtagene autoleucel for the treatment of relapsed/refractory MM in CARTITUDE-1, -2, and -4

Ciltacabtagene autoleucel (cilta-cel), an approved B-cell maturation antigen (BCMA)-directed CAR T-cell therapy, showed strong efficacy in heavily pre-treated patients with RRMM and in patients at earlier lines of therapy (LOT) in the single-arm CARTITUDE-1, multi-cohort CARTITUDE-2, and phase 3 CARTITUDE-4 trials [ 1 , 2 , 3 , 4 , 5 , 6 ]. The cilta-cel adverse event (AE) profile was consistent with that of the CAR-T class, which includes immune-related toxicities like cytokine release syndrome (CRS) and neurologic events like immune effector cell–associated neurotoxicity syndrome (ICANS) [ 6 , 7 ]. Reports of cranial nerve (CN) palsy (CNP) following CAR T-cell therapy are infrequent [ 2 , 8 , 9 , 10 , 11 , 12 ], and guidance on its management is needed. We describe clinical experience with CNP presentation and management after cilta-cel in CARTITUDE-1, CARTITUDE-2 cohorts A, B, and C, and CARTITUDE-4.