Influence on CAR T-cell Outcomes of Race, Ethnicity, and BMI

Faruqi AJ, Ligon JA, Borgman III PG, et al. The Impact of Race, Ethnicity, and Obesity on CAR T-Cell Therapy Outcomes. Blood Advances. 2022; (doi: 10.1182/bloodadvances.2022007676).

The effectiveness of chimeric antigen receptor (CAR) T-cell therapy on adult and pediatric patients with B-cell acute lymphoblastic leukemia (B-ALL) was not impacted by race, ethnicity, or obesity, nor did these factors cause differences in neurotoxicity. Researchers retrospectively assessed the effects of demographics and obesity on CAR T-cell therapy outcomes in patients with hematologic malignancies, with a primary focus on B-ALL, in five Phase I clinical trials. Of 139 CAR T-cell infusions for B-ALL, 29.5% of the patients were overweight or obese, while 28.8% were Hispanic and 3.6% were Black. Race, ethnicity, or body-mass index did not correlate with any differences in complete remission rates, neurotoxicity, or overall survival. Severe cytokine release syndrome was more likely among Hispanic patients than among white non-Hispanic patients, even after accounting for disease burden and age. A similar pattern was seen between the B-ALL cohort and patients with multiple myeloma and Non-Hodgkin Lymphoma, according to a descriptive analysis. While the findings indicate CAR T-cell therapy may benefit patients across a wide demographic spectrum, toxicity profiles may differ.  Efforts are needed to improve access to CART-cell for underrepresented populations and determine reasons of differential toxicity among demographic groups.   

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