Multiple Myeloma Hub How can neurotoxicity associated with CAR T-cell therapy in MM be managed?
Aug 26, 2025
In this engaging discussion, Dr. Peter Forsberg from the Colorado Blood Cancer Institute sheds light on the complexities of neurotoxicity related to CAR T-cell therapy in multiple myeloma. He discusses the critical need for early identification of symptoms and innovative management strategies, particularly focusing on immune effector cell-associated neurotoxicity syndrome (ICANS). Forsberg underscores how collaboration among healthcare professionals can refine diagnostic criteria and improve patient care as CAR T-cell therapies evolve.
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ICANS Is Distinct And Manageable
- ICANS is a common neurologic toxicity across CAR T constructs but occurs at relatively low rates with ide-cel and cilta-cel in myeloma.
- Management for ICANS is well-defined and primarily uses immunosuppression such as corticosteroids.
Real-World Atypical Neurotoxicities With Cilta-cel
- With cilta-cel we've observed atypical non-ICANS neurologic events in trials and real-world practice that are more diverse and less predictable.
- Some events like cranial nerve palsies tend to be reversible, while movement and neurocognitive toxicities can be harder to reverse.
Community Collaboration Drives Solutions
- The myeloma community is collaborating to define, identify, and manage diverse neurologic toxicities from CAR T therapy.
- Ongoing innovation across centers aims to improve risk identification, prevention, and treatments as CAR T integrates into myeloma care.