Risk for Second Primary Cancer May Be No Higher With CAR T-Cell Versus Standard of Care

THURSDAY, Sept. 12, 2024 (HealthDay News) -- The overall second primary malignancy (SPM) point estimate was 5.8 percent for patients receiving chimeric antigen receptor (CAR) T-cell therapy, according to a study published online Sept. 11 in Clinical Cancer Research.

Tobias Tix, from LMU Klinikum in Munich, and colleagues conducted a systematic review to delineate the frequency and subtypes of SPMs following CAR T-cell therapy in lymphoma and myeloma. A total of 326 SPMs were identified across 5,517 patients from 18 clinical trials and seven real-world studies.

The researchers found that the overall SPM point estimate was 5.8 percent with a median follow-up of 21.7 months. There were associations for SPM estimates with treatment setting (clinical trials > real-world settings), follow-up duration, and number of previous treatment lines. In a meta-regression model, these associations were confirmed as independent study-level risk factors for SPM. The risk for SPM was similar with either treatment strategy in a subgroup meta-analysis of four trials that randomly assigned patients to CAR T-cell therapy versus standard of care. In an analysis of SPM subtypes, the most common were hematologic malignancies, followed by solid tumors and nonmelanoma skin cancers (37, 27, and 16 percent, respectively). A small minority of events were T-cell malignancies (1.5 percent).

"By understanding the factors contributing to SPM development and implementing effective monitoring strategies, health care providers can optimize patient outcomes and ensure the long-term safety of CAR T-cell therapies," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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