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• W4379161738 abstract "<div>Abstract<p>Although CD19-directed chimeric antigen receptor T-cell therapy (CD19.CAR-T) has proven clinical efficacy for multiple refractory B-cell malignancies, over 50% of patients ultimately relapse. Recent evidence has underlined the critical role of the host in determining treatment responses. In this retrospective observational study of 106 patients with relapsed/refractory large B-cell lymphoma receiving standard-of-care CD19.CAR-T, we analyzed the impact of immunometabolic host features and detailed body composition measurements on post–CAR T clinical outcomes. We extracted muscle and adipose tissue distributions from prelymphodepletion CT images and assessed laboratory-based immuno-nutritional scores. Early responders displayed increased total abdominal adipose tissue deposits (TAT: 336 mm³ vs. 266 mm³, <i>P</i> = 0.008) and favorable immuno-nutritional scores compared to nonresponding patients. On univariate Cox regression analysis, visceral fat distribution, sarcopenia, and nutritional indices significantly impacted both progression-free (PFS) and overall survival (OS). Patients with a low skeletal muscle index (SMI; e.g.<34.5), a sarcopenia indicator, exhibited poor clinical outcomes (mOS 3.0 months vs. 17.6 months, log-rank <i>P</i> = 0.0026). Prognostically adverse immuno-nutritional scores were linked to inferior survival [low PNI: HR_OS, 6.31; 95% confidence interval (CI), 3.35–11.90; <i>P</i> < 0.001]. In a multivariable analysis adjusting for baseline Eastern Cooperative Oncology Group performance status, C-reactive protein, and lactate dehydrogenase, increased TAT was independently associated with improved clinical outcomes (adjusted HR_OS, 0.27; 95% CI, 0.08–0.90; <i>P</i> = 0.03). We noted particularly favorable treatment outcomes in patients with both increased abdominal fat and muscle mass (TAT^high/SMI^high: 1-year PFS 50%, 1-year OS 83%). These real-world data provide evidence for a role of body composition and immuno-nutritional status in the context of CD19.CAR-T and suggest that the obesity paradox may extend to modern T cell–based immunotherapies.</p><p><i><a href=https://aacrjournals.org/cancerimmunolres/article/doi/10.1158/2326-6066.CIR-23-0313 target=_blank>See related Spotlight by Nawas and Scordo, p. 704</a></i></p></div>" @default.
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• W4379161738 date "2023-06-02" @default.
• W4379161738 modified "2023-10-17" @default.
• W4379161738 title "Data from Influence of Adipose Tissue Distribution, Sarcopenia, and Nutritional Status on Clinical Outcomes After CD19 CAR T-cell Therapy" @default.
• W4379161738 doi "https://doi.org/10.1158/2326-6066.c.6633140.v2" @default.
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