TOPLINE:

Chimeric antigen receptor (CAR) T-cell therapy for cancer led to better outcomes in patients with autoimmune diseases than in those without, a cohort study found.

METHODOLOGY:

• A retrospective cohort study analyzed the impact of preexisting autoimmune diseases among patients who received CAR T-cell therapy for cancer.
• A total of 1321 patients (mean age at admission, 60.2 years; 35.7% women; 70.4% White) received CAR T-cell therapy for cancer (63% with non-Hodgkin lymphoma) with hospitalizations between 2021 and 2022.
• The primary outcome was a composite of major toxicity, defined as having at least one condition such as certain syndromes (cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, or hemophagocytic lymphohistiocytosis), sepsis, pneumonia, intubation, acute kidney injury, or neutropenia.
• Data on demographics, comorbidities, cancer type, and specific CAR T-cell products were evaluated.

TAKEAWAY:

• Among the patients who received CAR T-cell therapy, 62 (4.7%) had preexisting autoimmune diseases, most commonly rheumatoid arthritis (33.9%), psoriasis (14.5%), and ulcerative colitis (12.9%).
• Patients with preexisting autoimmune diseases had significantly shorter hospital stays than those without underlying autoimmunity, with a mean reduction of 2.1 days (95% CI, 0.5-3.6).
• Preexisting autoimmune diseases were linked to lower odds of major toxicity (adjusted odds ratio [aOR], 0.55; 95% CI, 0.31-0.99), particularly in multiple myeloma cases (aOR, 0.09; 95% CI, 0.02-0.51).
• No significant association was found between preexisting autoimmune diseases and neutropenia, tocilizumab use, or in-hospital mortality.

IN PRACTICE:

“These findings offered reassurance that CAR T-cell outcomes were not worse for patients with preexisting autoimmune diseases and provided additional controlled safety data for ongoing clinical trials evaluating the efficacy of CAR T-cell therapy in autoimmune diseases,” the authors wrote.

SOURCE:

This study was led by Gregory J. Challener, MD, Massachusetts General Hospital and Harvard Medical School, Boston. It was published online on October 19, 2025, in ACR Open Rheumatology.

LIMITATIONS:

The study included a heterogeneous population with different autoimmune diseases, making it difficult to determine outcomes for specific conditions. The small sample size limited assessment of differences within subgroups. The study lacked data on tumor burden, CAR T-cell dosage, and important in-hospital medication use. 

DISCLOSURES:

One author declared being supported by the National Institutes of Health. Another author was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Heart, Lung, and Blood Institute; Rheumatology Research Foundation; and other sources and served as a consultant for various pharmaceutical and therapeutic companies. Two authors reported receiving research support from and serving as consultants for various companies. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.