58P - Cardiovascular outcomes of novel CAR-T cell therapies: A meta-analysis of incidence, risk factors, and management of cardiotoxicity

Background

Chimeric Antigen Receptor T-cell (CAR-T) therapies have revolutionized the treatment of certain hematologic malignancies. Despite their efficacy, these therapies are associated with significant adverse effects, including cardiotoxicity. Understanding the incidence, risk factors, and management strategies for CAR-T therapy-related cardiotoxicity is crucial for optimizing patient outcomes and improving safety profiles.

Methods

A systematic review and meta-analysis were conducted by searching PubMed, Embase, and Cochrane databases for studies published up to June 2024 that reported on cardiovascular outcomes in patients undergoing CAR-T therapy. Inclusion criteria were studies that provided detailed information on the incidence of cardiotoxic events, associated risk factors, and management strategies. Data were extracted independently by two reviewers and pooled using random-effects models to account for heterogeneity among studies. Subgroup analyses were performed to identify specific risk factors and effective management approaches.

Results

A total of 25 studies comprising 3,500 patients were included in the meta-analysis. The pooled incidence of cardiotoxic events among CAR-T therapy recipients was 18% (95% CI: 12%-25%). The most common cardiovascular complications were heart failure (10%), arrhythmias (6%), and myocardial infarction (2%). Risk factors significantly associated with increased cardiotoxicity included pre-existing cardiovascular disease (OR: 3.5, 95% CI: 2.1-5.8), older age (OR: 2.0, 95% CI: 1.3-3.2), and higher doses of CAR-T cells (OR: 1.8, 95% CI: 1.1-3.0). Effective management strategies identified included the use of beta-blockers, ACE inhibitors, and careful monitoring of cardiac function throughout the treatment course.

Conclusions

CAR-T cell therapies, while highly effective for treating hematologic malignancies, present a significant risk of cardiotoxicity. This meta-analysis highlights the importance of identifying high-risk patients and implementing proactive management strategies to mitigate these risks. Future research should focus on refining CAR-T protocols to minimize cardiotoxic effects and improve patient outcomes.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.