Hematologic Oncology Update Toxicities Associated with CAR T-Cell Therapy — An Interview with Dr Matthew Lunning
Dec 4, 2025
Dr. Matthew Lunning, a hematologist-oncologist from the Fred and Pamela Buffett Cancer Center, shares vital insights on managing CAR T-cell therapy toxicities. He discusses the evolution of CRS and ICANS management and highlights the importance of long-term studies and referral timing. Lunning compares CAR T products, emphasizing the advantages of lisocabtagene for older patients. He also shares intriguing case studies that reveal the nuances of treatment outcomes, particularly in managing neurotoxic effects and patient quality of life.
AI Snips
Chapters
Transcript
Episode notes
Prefer Liso‑Cel For Older Patients
- Do consider liso-cel preferentially for older patients to lower the risk of severe neurotoxicity.
- Assess comorbidities but avoid using chronological age alone to exclude patients from CAR T.
Frontline Bispecifics Will Shift Sequencing
- Bispecific antibodies moving into frontline therapy will create a new 'bispecific‑exposed' population with unknown effects on CAR T manufacturing and outcomes.
- Trial participation will shape future sequencing decisions between bispecifics and CAR T.
Sequence BTK Before CAR T In Mantle Cell
- Do use BTK inhibitors before CAR T in mantle cell lymphoma when possible and avoid stopping a covalent BTK without a plan.
- Expect earlier and higher‑grade CRS/ICANS in mantle cell and plan monitoring and mitigation accordingly.