To compare the safety, efficacy, and CAR T-cell expansion associated with infusion through implanted ports versus PICC/CVC access in adults with large B-cell lymphoma.
Approach:
Design and population: Single-center retrospective analysis of 504 patients treated with commercially available CAR T-cells from January 2018 through March 2025; follow-up was cut off in May 2025.
Groups and outcomes: CAR T-cells were infused through a port in 202 patients and through a PICC/CVC in 302. Investigators assessed toxicities, line complications, response, progression-free and overall survival, and peripheral-blood CAR T-cell expansion.
Key Findings:
CRS occurred in 87.5% of patients; any-grade ICANS occurred in 56.2%, and grade 3–4 ICANS in 35.1%. Infection and prolonged cytopenia rates were comparable between access groups.
VTE was less frequent with ports than with PICC/CVC access (3.0% vs 9.3%; p = 0.006). Multivariable analyses found a significant association between port use and lower VTE rates.
Day 30 and day 90 complete metabolic response rates did not differ significantly between groups. Median PFS and OS also showed no significant between-group differences.
Interpretation:
The authors report that CAR T-cell infusion through an implanted port was safe and effective compared with PICC/CVC infusion in this cohort. They also note that using an existing port may avoid the burden of adding or modifying central venous access.
Limitations:
The study was retrospective and conducted at a single center.
CAR T-cell expansion was evaluated in a subset of 128 patients.
The provided article context ends before the discussion is complete.
Conclusion:
In this single-center cohort, implanted-port infusion was associated with lower VTE rates than PICC/CVC access, with no significant differences in response or survival outcomes. The findings support ports as a potential option for CAR T-cell infusion, but prospective studies are needed to confirm these results.
by Zachary E. Hunzeker, Anath Lionel, Xiaowen Sun, Lei Feng, Sairah Ahmed, Amy Ayers, Michelly de Castro, Jaimole Varghese, Karla Ow, Taylor Cain, Minifrida Santiago, Sreekala Nair, Jeremy Ramdial, Elizabeth J. Shpall, Sattva S. Neelapu, Paolo Strati
Roswell Park Comprehensive Cancer Center performs more than 100 surgeries for patients with liver and pancreatic cancers every year, making it a high-volume center specializing in these rare diseases.
