The Tumor Microenvironment and Inflammation Influence toxicity in patients with Large B Cell Lymphoma Treated with Axicabtagene Ciloleucel [RNA-Seq]

We aimed to identify factors that place patients with Large B Cell Lymphoma at higher risk of developing severe immune mediated toxicities after CAR T infusion. Tumor biopsies were taken within one month prior to CAR T infusion for evaluation of gene expression. In pre-treatment patient tumor biopsies, we found that gene expression of myeloid markers was associated with higher toxicity. Tumor biopsies were taken within one month of CAR T infusion in a cohort of 25 patients and prospectively snap-frozen. We compared gene expression of the pre-treatment biopsy samples of patients who developed severe immune mediated toxicities ( Grade > 3 neurotoxicity) vs. those with grade 0-2 toxcities after CAR T infusion. We compared patients who went on to have a durable response (DR) to those with a non-durable response (NDR) in patients that had sufficient follow up (minimum 6 months post-CAR T infusion).