Optimizing Post–CAR T Cell Monitoring: Evidence Across Lisocabtagene Maraleucel (liso-cel) Pivotal Clinical Trials and Real-World Experience

Panelists discuss how CAR T cell therapy has transformed lymphoma treatment with multiple FDA-approved products showing 70% to 80% overall response rates and 50% to 60% complete response rates across different B-cell malignancies, while emphasizing the importance of comparing clinical trial data with real-world evidence to understand true efficacy and safety profiles.

Panelists discuss how CAR T monitoring requirements have evolved from initially conservative inpatient approaches to more flexible outpatient strategies, exploring ways to reduce the burden of mandatory 30-plus-day proximity requirements while maintaining patient safety and improving treatment accessibility.

Panelists discuss how data from over 1500 patients receiving liso-cel shows consistent cytokine release syndrome (CRS) outcomes between clinical trials and real-world settings, with most CRS events occurring within the first 2 weeks and late-onset events being rare and manageable, supporting potential changes to monitoring protocols.

Panelists discuss how immune cell–associated neurotoxicity syndrome data mirrors cytokine release syndrome patterns, with 70% of patients experiencing no neurotoxicity, only 5% to 7% developing grade 3 or higher events, and most toxicities occurring early and resolving within 1 week, further supporting arguments for modified monitoring approaches.

Panelists discuss how improving CAR T accessibility through reduced monitoring requirements could strengthen its position against bispecific antibodies in treatment decision-making, emphasizing that access considerations should only influence therapy choice when efficacy and safety are comparable, not when CAR T demonstrates superior outcomes.