Prevalence of adverse events following T-cell engaging bispecific antibodies (bsAbs) and chimeric antigen receptor (CAR) T-cell therapy in patients with metastatic castrate-resistant prostate cancer (mCRPC): A meta-analysis.

• DOI: 10.1200/jco.2025.43.5_suppl.128
• Publication Date: 2025-02-18T14:35:11Z
• Authors: Abhiraj Saxena; Nicholas Zorko; Vivek Narayan; Biren Saraiya; William J Tester; Grace L. Lu-Yao; William Kevin Kelly; Kevin Kayvan Zarrabi
• Keywords: Bispecific antibody

128 Background: T-cell engaging bsAbs and CAR therapy have shown exceptional success in treating multiple hematologic malignancies. More recently, been FDA-approved to treat uveal melanoma small cell lung cancer, demonstrating proof-of-concept for immune therapies beyond checkpoint inhibition effectively solid tumors. CAR-T are presently undergoing evaluation trials patients with mCRPC. Despite early successes these classes of therapy, there ongoing challenges including dose-limiting toxicity, ‘on-target, off-tumor’ immune-effector related toxicity. This systematic review analyzes publicly available safety derived from clinical trials. Methods: An electronic search through PubMed, CINHAL, Scopus, Ovid was done identify phase I/II evaluating or mCRPC reported prior 9/30/2024. Treatment-related adverse events (TRAE) were collected, focusing on prevalence versus CAR-T. A random effects model used analysis. Results: Eleven 511 evaluated bsAbs, 5 55 patents studied therapies. Mean patient age 67 years [95% CI: 63, 71]. Cytokine release syndrome (CRS) occurred 49% [24, 75] patients; 53% [17, 86] compared 43% [28, 59] Only 4% [2, 7] had CRS grade ≥3; 14% 43] 3% 6] (p=0.05). Neurologic TRAEs 11% [3, 31] 39% [22, 60] 5% 13] (p= <0.01). Hematologic 38% [14, 71] 34% [8, [9, bsAbs. Hepatic 31% [12, 25% 44] 81] 0.55). However, 8% 20] ≥3 hepatic TRAEs, 21% [5, 51] 10] (p=0.03). Musculoskeletal/dermatologic seen 30% 37]; 38] 29% 58] (p=0.89). Renal 15% [10, 23] 24] 0.50). Gastrointestinal 18% 33] 42] 19% 36] 0.69). Conclusions: In mCRPC, produce similar hematological, musculoskeletal/dermatologic, renal gastrointestinal TRAE rates. significantly higher rates all-grade neurologic, therapy. These data highlight the need appreciate differences toxicity profiles two practice appropriate vigilance during treatment.