At the 2026 National ICE-T Congress in Orlando, Florida, sessions focused on bringing CAR T-cell therapy and bispecific antibodies to community practice. These presentations touched upon toxicity recognition and management across lymphoma, myeloma, and leukemia.
Program director Megan Melody, MD, MS, a malignant hematologist specializing in lymphoma and cellular therapy and clinical director of Cellular Therapy at Tampa General Hospital, spoke with CancerNetwork® about which aspects of CAR T-cell care are advancing fastest, and which are lagging behind.
Transcript:
CancerNetwork: This meeting spanned efficacy, toxicity, and different themes of access across multiple disease states. Which of those 3 areas do you think is advancing the fastest right now, and which one would be lagging by comparison?
Melody: In terms of toxicity management, things like neurotoxicity, cytokine release syndrome [CRS], or ICANS are still some pretty scary terms we use when talking about CAR T-cell therapy. But I think most of the clinicians in the room today feel quite comfortable managing these toxicities in the acute setting, and it is important to note that the most recent studies evaluating CAR T-cell therapies, at least for the treatment of lymphoma, have shown that these acute toxicities are not fatal and that no one died from them, which really demonstrates how well they are now managed in the acute care setting.
Something that was talked about a lot in our last few sessions was delayed-onset neurotoxicity seen with these anti-BCMA CAR T-cell products and some new, novel toxicities we are seeing as we develop new CAR T-cell constructs that we will need to continue working on recognizing as patients return to the community, along with the proper management of these in the post-CAR T-cell setting. For example, Parkinsonism in the post-CAR T-cell setting is not managed with the typical carbidopa and levodopa [Sinemet] that is used to manage Parkinsonism outside the setting of CAR T-cell therapy. Recognizing that is a bit lagging.
Another hot topic is these barriers to CAR T, and how we bring CAR T-cell therapy—and I would say more urgently and more currently, bispecific antibodies—into the community. [It is about] how we do this safely and efficaciously, and how we educate community physicians and emergency room physicians about these toxicities: how to recognize and manage them, or at least when to call the local oncologist.
