Medidata AI: New Research on Concurrence of CRS and ICANS in CAR T-cell Treatments

Chimeric antigen receptor (CAR) T-cell treatment is a promising immunotherapy for multiple hematological cancers, especially for patients who have exhausted other treatment options. While CAR-T therapy represents hope for these patients, it can come with serious and life-threatening side effects.

Cytokine Release Syndrome (CRS)—sometimes called a cytokine storm—is one of the most common CAR-T cell therapy side effects, caused by an overly excessive response to CAR-T treatments. Another is Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS), which frequently occurs following a CRS event. Despite its impact on clinical development, the frequency, severity, and timing of ICANS incidents relative to CRS have not yet been studied in a diverse patient population. 

Medidata’s prior work has extensively focused on understanding and predicting the likelihood of a patient experiencing a CRS event. The work presented at the 5th European CAR T-cell meeting, co-hosted by the EHA and the EBMT, builds upon this earlier, groundbreaking work and examines the association of ICANS and CRS.

Using the largest cohort of patients on CD19-targeted CAR-T therapies ever studied to date, the team analyzed 582 patients with relapsed or refractory B-Cell Acute Lymphoblastic Leukemia or Non Hodgkin’s Lymphoma.

They found ICANS occurrence and severity appear to be driven by CRS occurrence. But while CRS incidence can be decreased by administering a preemptive treatment with IL6R blockade or corticosteroids, these treatments do not directly target pathways underlying ICANS and therefore don’t lead to preventing incidence of ICANS. This means that ICANS management would require a distinct therapeutic approach. 

Learn more about the Medidata AI team’s novel research by viewing their poster.