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Cancer

Pre-CAR-T Pulmonary Function Tests May Predict Toxicities in Lymphoma Patients Undergoing CAR-T Therapy

Strategic Insights

— 1 min read

Researchers at the University of Texas MD Anderson Cancer Center conducted a retrospective study of 66 patients who underwent CAR-T therapy to examine the association between pre-CAR-T pulmonary function testing (PFT) and subsequent complications. The study found that higher lung function scores correlated with increased risk of cytokine release syndrome (CRS), while better forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were protective against immune effector cell-associated neurotoxicity syndrome (ICANS). The research suggests that pre-CAR-T PFTs may help clinicians understand the risk for toxicities after CAR-T cell therapy.

Key Takeaways:

  • Higher lung function scores were associated with increased risk of CRS (OR 4.3, 95% CI, 1.4-29, P = .048) in patients undergoing CAR-T therapy.
  • Better FEV1 (OR = 0.96, 95% CI, 0.93-0.99, P = .05) and FVC (OR = 0.96, 95% CI 0.92-0.99, P = .03) were protective against ICANS.
  • PFT abnormalities were not associated with early or late mortality.
  • The combination of pre-CAR-T spirometry and diffusing capacity of the lungs for carbon monoxide (DLCO) may help clinicians understand the risk for toxicities after CAR-T cell therapy.
  • The study used a retrospective analysis of 66 patients who underwent CAR-T therapy at the University of Texas MD Anderson Cancer Center.
  • The research concluded that pre-CAR-T PFTs may be a useful tool for predicting toxicities after CAR-T cell therapy.
  • The study's authors included Ajay Sheshadri from the University of Texas MD Anderson Cancer Center, among others.

Statistics:

  • 66 patients underwent CAR-T therapy with pre-CAR-T PFTs within 12 months prior to lymphodepletion.
  • 218 individuals underwent CAR-T therapy in total, but only 66 had pre-CAR-T PFTs performed.
  • The study found that higher lung function scores correlated with increased risk of CRS (OR 4.3, 95% CI, 1.4-29, P = .048).
  • Better FEV1 and FVC were protective against ICANS in the study (OR = 0.96, 95% CI, 0.93-0.99, P = .05 for FEV1, and OR = 0.96, 95% CI 0.92-0.99, P = .03 for FVC).

Sources:

  • Clinical Lymphoma Myeloma and Leukemia, 2025;25(7):520-526.
  • NewsRx, Investigators at University of Texas MD Anderson Cancer Center Report Findings in Cell Therapy (Role of Pulmonary Function Tests To Predict Complications After Chimeric Antigen Receptor T-cell Therapy). Hematology Week. July 14, 2025; p 175.

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