Race, ethnicity, and body mass index (BMI) do not appear to impact the efficacy of chimeric antigen receptor (CAR) T-cell therapy in heavily pretreated patients with B-cell acute lymphoblastic leukemia (B-ALL), according to research published in Blood Advances.
However, the research showed that Hispanic patients were more likely than non-Hispanic White patients to experience severe cytokine release syndrome (CRS) after CAR T-cell therapy.
Researchers retrospectively evaluated the impact of demographic factors on CAR T-cell therapy outcomes in patients with hematologic malignancies, focusing primary on young adult and pediatric patients with B-ALL. The patients were treated across 5 phase 1 trials at the National Cancer Institute between 2012 and 2021.
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A total of 139 patients with B-ALL were included. The population was 57.1% non-Hispanic White, 28.8% Hispanic, and 3.6% Black. The median age was 15.10 years (interquartile range, 9.55-21.20), and 29.5% of patients were overweight or obese.
The rate of complete remission was 67.6%, the rate of grade 3 or higher CRS was 18%, and the rate of neurotoxicity was 20.9%. The median overall survival was 12.2 months.
The researchers found that race/ethnicity, sex, and BMI were not associated with complete remission rates, neurotoxicity, or overall survival.
However, Hispanic patients had a 3-fold higher risk of developing grade 3 or higher CRS compared with non-Hispanic White patients (odds ratio [OR], 3.24; 95% P =.001). When the researchers adjusted for disease burden and age, Hispanic patients were still more likely to experience severe CRS (OR, 4.5; P =.001).
“Our findings suggest CAR T-cell therapy may provide substantial benefit across a range of demographics characteristics; [however,] toxicity profiles may vary,” the researchers concluded. “Although our results highlight the potential of CAR T-cell therapy to improve outcomes in populations who have worse chemotherapy outcomes, it is important to recognize combating cancer health disparities will require a multifaceted approach that incorporates not only better access to emerging therapies such as CAR T cells but also improved prevention and relapse mitigation strategies.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.
Reference
Faruqi AJ, Ligon JA, Borgman P, et al. The impact of race, ethnicity, and obesity on CAR T-cell therapy outcomes. Blood Adv. 2022;6(23):6040-6050. doi:10.1182/bloodadvances.2022007676
This article originally appeared on Hematology Advisor
