A new study has raised awareness about the risk of second primary malignancies (SPM) in patients treated with chimeric antigen receptor (CAR) T-cell therapy for hematologic cancers like lymphoma and myeloma. CAR-T therapy, a powerful immunotherapy, is known for its effectiveness, but this research highlights potential long-term adverse effects.
Researchers from the Memorial Sloan Kettering Cancer Research Institute, conducted a systematic review and meta-analysis of 18 clinical trials and 7 real-world studies, involving 5,517 patients. They identified 326 cases of SPMs, with an overall estimated risk of 6.0% ((95% confidence interval, 4.8%–7.4%) over a median follow-up period of 21.7 months. Hematologic malignancies were the most common SPMs (37%), followed by solid tumours (27%) and non-melanoma skin cancers (16%).
The study revealed that SPM risks were influenced by factors such as treatment setting, follow-up duration, and the number of prior treatments. Interestingly, a comparison of CAR-T with standard-of-care treatments showed no significant difference in SPM risk between the two (P = 0.92).
While SPMs are a clinically relevant concern, the study emphasizes that CAR-T therapy does not seem to carry a higher risk of SPMs compared to previous treatments. The findings underscore the importance of long-term monitoring for patients undergoing CAR-T therapy to manage potential secondary cancers.
Helena Bradbury, EMJ
Reference
Tix T et al. Second Primary Malignancies after CAR T-Cell Therapy: A Systematic Review and Meta-analysis of 5,517 Lymphoma and Myeloma Patients. Clinical Cancer Research. 2024
