Dr. Kumar on Navigating CAR T-Cell Therapy–Related Toxicities in MCL

Anita Kumar, MD, medical oncologist, Regional Care Network Medical Site Director, MSK Basking Ridge, Memorial Sloan Kettering Cancer Center, discusses navigating CAR T-cell therapy–related toxicities in mantle cell lymphoma (MCL).

In MCL, treatment with the CAR T-cell therapy brexucabtagene autoleucel (brexu-cel; Tecartus) is associated with a risk of adverse effects, including cytokine release syndrome (CRS) and neurotoxicity, Kumar says. Findings from the phase 2 ZUMA-2 trial (NCT02601313), which data led to the July 2020 FDA approval of brexu-cel, revealed that 15% and 31% of patients developed grade 3 or higher CRS and neurotoxicity, respectively.

To mitigate the toxicity risk with brexu-cel, patients should be well selected, Kumar explains. Factors such as age, comorbidities, and disease status, including tumor burden and time of initial treatment, could be potential predictors for toxicity, Kumar says. As such, the field should work toward developing a greater understanding of how to select patients to optimize efficacy and quality of life, Kumar concludes.