Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myeloma

IntroductionEvaluating predictive biomarkers early in treatment, clinicians can anticipate Q7 77 78 survival outcomes. Ferritin has emerged as a promising predictor of clinical 79 outcomes in multiple myeloma (MM) patients undergoing chimeric antigen patient responses and tailor therapeutic strategi...

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Main Authors: Eider F. Moreno-Cortes, Mariano Arribas, David A. Martinez-Gamboa, Juana Figueroa-Aguirre, Rohan Patel, Daniel Bihnam, Udit Yadav, J. Erin Wiedmeier-Nutor, Leif Bergsagel, Saurabh Chhabra, Rafael Fonseca, Januario E. Castro
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Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Hematology
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Online Access:https://www.frontiersin.org/articles/10.3389/frhem.2025.1618331/full
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author Eider F. Moreno-Cortes
Eider F. Moreno-Cortes
Mariano Arribas
David A. Martinez-Gamboa
David A. Martinez-Gamboa
Juana Figueroa-Aguirre
Juana Figueroa-Aguirre
Rohan Patel
Daniel Bihnam
Udit Yadav
J. Erin Wiedmeier-Nutor
Leif Bergsagel
Saurabh Chhabra
Rafael Fonseca
Januario E. Castro
Januario E. Castro
author_facet Eider F. Moreno-Cortes
Eider F. Moreno-Cortes
Mariano Arribas
David A. Martinez-Gamboa
David A. Martinez-Gamboa
Juana Figueroa-Aguirre
Juana Figueroa-Aguirre
Rohan Patel
Daniel Bihnam
Udit Yadav
J. Erin Wiedmeier-Nutor
Leif Bergsagel
Saurabh Chhabra
Rafael Fonseca
Januario E. Castro
Januario E. Castro
author_sort Eider F. Moreno-Cortes
collection DOAJ
description IntroductionEvaluating predictive biomarkers early in treatment, clinicians can anticipate Q7 77 78 survival outcomes. Ferritin has emerged as a promising predictor of clinical 79 outcomes in multiple myeloma (MM) patients undergoing chimeric antigen patient responses and tailor therapeutic strategies to enhance efficacy and 80 receptor (CAR) T-cell therapy.MethodsIn this study, we investigated the prognostic 81 value of ferritin and C-reactive protein (CRP) as biomarkers in CAR T-cell 82 83 ferritin and CRP levels at two time points pre-infusion (Day-0) and pre- 84 lymphodepleting chemotherapy (LDC) and their association with clinical therapy for MM. This study’s objective was to evaluate the correlation between 85 response outcomes. We retrospectively analyzed outcomes from 52 relapsed/ 86 refractory MM (RRMM) patients who received either idecabtagene vicleucel or 87 ciltacabtagene autoleucel CAR T-cell therapies.ResultsLow ferritin levels at Day-0 and 88 pre-LDC were able to predict better responses regardless of the CAR T cell 89 product (hazard ratio [HR] 0.01 (95% CI 0.05–0.5); p=0.001, (HR 0.05 95% CI 90 0.01-0.2, p=<0.0069), respectively. Low ferritin + low CRP were able to predict responses at Day-0 and pre-LDC HR 0.3 (95% CI 0.07-1.3); p=0.04, HR 0.26 (95% CI 0.03-2.1), p=0.04, respectively.DiscussionOur results indicate that ferritin and CRP 93 levels represent promising predictive biomarkers that may refine CAR T-cell 94 therapy response by enabling better patient stratification and personalized 95 treatment approaches. Our study underscores the need for their integration 96 into routine clinical practice for MM management.ConclusionsFuture prospective studies are 97 warranted to validate these findings and explore the mechanistic link between 98 99 100 101 102 elevated ferritin levels, immune activation states, and CAR T-cell efficacy.
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spelling doaj-art-51a6c2b5507841d9af3c8ffe391b64d12025-08-20T03:36:54ZengFrontiers Media S.A.Frontiers in Hematology2813-39352025-08-01410.3389/frhem.2025.16183311618331Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myelomaEider F. Moreno-Cortes0Eider F. Moreno-Cortes1Mariano Arribas2David A. Martinez-Gamboa3David A. Martinez-Gamboa4Juana Figueroa-Aguirre5Juana Figueroa-Aguirre6Rohan Patel7Daniel Bihnam8Udit Yadav9J. Erin Wiedmeier-Nutor10Leif Bergsagel11Saurabh Chhabra12Rafael Fonseca13Januario E. Castro14Januario E. Castro15Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesCancer Research and Cellular Therapy Laboratory, Mayo Clinic, Arizona, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesCancer Research and Cellular Therapy Laboratory, Mayo Clinic, Arizona, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesCancer Research and Cellular Therapy Laboratory, Mayo Clinic, Arizona, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United StatesCancer Research and Cellular Therapy Laboratory, Mayo Clinic, Arizona, Phoenix, AZ, United StatesIntroductionEvaluating predictive biomarkers early in treatment, clinicians can anticipate Q7 77 78 survival outcomes. Ferritin has emerged as a promising predictor of clinical 79 outcomes in multiple myeloma (MM) patients undergoing chimeric antigen patient responses and tailor therapeutic strategies to enhance efficacy and 80 receptor (CAR) T-cell therapy.MethodsIn this study, we investigated the prognostic 81 value of ferritin and C-reactive protein (CRP) as biomarkers in CAR T-cell 82 83 ferritin and CRP levels at two time points pre-infusion (Day-0) and pre- 84 lymphodepleting chemotherapy (LDC) and their association with clinical therapy for MM. This study’s objective was to evaluate the correlation between 85 response outcomes. We retrospectively analyzed outcomes from 52 relapsed/ 86 refractory MM (RRMM) patients who received either idecabtagene vicleucel or 87 ciltacabtagene autoleucel CAR T-cell therapies.ResultsLow ferritin levels at Day-0 and 88 pre-LDC were able to predict better responses regardless of the CAR T cell 89 product (hazard ratio [HR] 0.01 (95% CI 0.05–0.5); p=0.001, (HR 0.05 95% CI 90 0.01-0.2, p=<0.0069), respectively. Low ferritin + low CRP were able to predict responses at Day-0 and pre-LDC HR 0.3 (95% CI 0.07-1.3); p=0.04, HR 0.26 (95% CI 0.03-2.1), p=0.04, respectively.DiscussionOur results indicate that ferritin and CRP 93 levels represent promising predictive biomarkers that may refine CAR T-cell 94 therapy response by enabling better patient stratification and personalized 95 treatment approaches. Our study underscores the need for their integration 96 into routine clinical practice for MM management.ConclusionsFuture prospective studies are 97 warranted to validate these findings and explore the mechanistic link between 98 99 100 101 102 elevated ferritin levels, immune activation states, and CAR T-cell efficacy.https://www.frontiersin.org/articles/10.3389/frhem.2025.1618331/fullCAR T cellmultiple myelomaferritinC reactive protein (CRP)ciltacabtagene autoleucelidecabtagene vicleucel
spellingShingle Eider F. Moreno-Cortes
Eider F. Moreno-Cortes
Mariano Arribas
David A. Martinez-Gamboa
David A. Martinez-Gamboa
Juana Figueroa-Aguirre
Juana Figueroa-Aguirre
Rohan Patel
Daniel Bihnam
Udit Yadav
J. Erin Wiedmeier-Nutor
Leif Bergsagel
Saurabh Chhabra
Rafael Fonseca
Januario E. Castro
Januario E. Castro
Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myeloma
Frontiers in Hematology
CAR T cell
multiple myeloma
ferritin
C reactive protein (CRP)
ciltacabtagene autoleucel
idecabtagene vicleucel
title Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myeloma
title_full Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myeloma
title_fullStr Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myeloma
title_full_unstemmed Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myeloma
title_short Pre-infusion ferritin a predictive biomarker for CAR T-cell therapy in R/R multiple myeloma
title_sort pre infusion ferritin a predictive biomarker for car t cell therapy in r r multiple myeloma
topic CAR T cell
multiple myeloma
ferritin
C reactive protein (CRP)
ciltacabtagene autoleucel
idecabtagene vicleucel
url https://www.frontiersin.org/articles/10.3389/frhem.2025.1618331/full
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