Relationship Between Early Use of Tocilizumab During CAR-T Therapy For Multiple Myeloma And Cardiovascular Risk and Progression Free Survival

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ID: 316540
2026
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Abstract
Abstract Chimeric antigen receptor-T cell (CAR-T) therapies are approved for refractory and relapsed multiple myeloma (MM). Patients with MM have high cardiovascular disease burden due to age and cardiotoxic treatments. Retrospective studies in patients who develop severe grades of cytokine release syndrome (CRS) demonstrated a 20-30% major cardiovascular adverse event (MACE) rate. Early use of the interleukin-6 receptor antagonist, tocilizumab, to reverse CRS may lower rates of MACE. This observational study sought to examine the relationship between early use of tocilizumab and the development of MACE. Single-center retrospective chart review of adults undergoing CAR-T therapy for MM between 2017 and 2023. MACE was defined as composite of myocardial injury, heart failure, stroke, arrhythmias and cardiovascular death over a median period of 12 months. The secondary outcomes were progression free survival (PFS) and overall survival (OS). MACE incidence was estimated using the cumulative incidence function with non-cardiovascular death as a competing risk and compared by Gray’s test, and PFS/OS were analyzed using Kaplan–Meier methods with log-rank tests. Of the 145 patients studied, CRS occurred in 120 patients (82%). Of those with CRS, 107 (89%) received tocilizumab within 24 hours. Within 1 year of therapy, 14 patients (9.7%) experienced MACE. Only patients with CRS developed MACE. The incidence of MACE was 8% [95% CI: 5%, 14%] at 6 months and 11% [95% CI: 7%, 19%] at 12 months. Progression free survival at 12 months was 58% [95% CI: 50%, 68%]. PFS and OS did not differ significantly based on incidence on CRS.
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Authors Sophia Golec, Weijia Fu, Erin Moshier, Ariel Peleg, Brunna Pileggi, Adriana Rossi, Gagan Sahni
Journal European Heart Journal Open
Year 2026
DOI
10.1093/ehjopen/oeag097
URL
https://doi.org/10.1093/ehjopen/oeag097
Keywords Keywords not found

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