Browsing by Author "Parekh, Samir"

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    CAR T-cell toxicities: from bedside to bench, how novel toxicities inform laboratory investigations
    (American Society of Hematology, 2024) Perna, Fabiana; Parekh, Samir; Diorio, Caroline; Smith, Melody; Subklewe, Marion; Mehta, Rakesh; Locke, Frederick L.; Shah, Nirali N.; Medicine, School of Medicine
    Multiple chimeric antigen receptor (CAR) T-cell therapies are US Food and Drug Administration-approved, and several are under development. Although effective for some cancers, toxicities remain a limitation. The most common toxicities, that is, cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, are well described. With increasing utilization, providers worldwide are reporting other emergent and often complicated toxicities. Given the evolving toxicity profiles and urgent need to catalog these emerging and emergent CAR T-cell toxicities and describe management approaches, the American Society of Hematology Subcommittee on Emerging Gene and Cell Therapies organized the first scientific workshop on CAR T-cell toxicities during the annual society meeting. The workshop functioned to (1) aggregate reports of CAR T-cell emergent toxicities, including movement disorders after B-cell maturation antigen CAR T cell, coagulation abnormalities, and prolonged cytopenia; (2) disseminate bedside-to-bench efforts elucidating pathophysiological mechanisms of CAR T-cell toxicities, including the intestinal microbiota and systemic immune dysregulation; and (3) highlight gaps in the availability of clinical tests, such as cytokine measurements, which could be used to expand our knowledge around the monitoring of toxicities. Key themes emerged. First, although clinical manifestations may develop before the pathophysiologic mechanisms are understood, they must be studied to aid in the detection and prevention of such toxicities. Second, systemic immune dysregulation appears to be central to these emergent toxicities, and research is needed to elucidate the links between tumors, CAR T cells, and microbiota. Finally, there was a consensus around the urgency to create a repository to capture emergent CAR T-cell toxicities and the real-world management.
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    Summary of the 2019 Blood and Marrow Transplant Clinical Trials Network Myeloma Intergroup Workshop on Minimal Residual Disease and Immune Profiling
    (Elsevier, 2020-10) Holstein, Sarah A.; Howard, Alan; Avigan, David; Bhutani, Manisha; Cohen, Adam D.; Costa, Luciano J.; Dhodapkar, Madhav V.; Gay, Francesca; Gormley, Nicole; Green, Damian J.; Hillengass, Jens; Korde, Neha; Li, Zihai; Mailankody, Sham; Neri, Paola; Parekh, Samir; Pasquini, Marcelo C.; Puig, Noemi; Roodman, G. David; Samur, Mehmet Kemal; Shah, Nina; Shah, Urvi A.; Shi, Qian; Spencer, Andrew; Suman, Vera J.; Usmani, Saad Z.; McCarthy, Philip L.; Medicine, School of Medicine
    The Blood and Marrow Transplant Clinical Trials Network (BMT CTN) Myeloma Intergroup has organized an annual workshop focused on minimal residual disease (MRD) testing and immune profiling (IP) in multiple myeloma since 2016. In 2019, the workshop took place as an American Society of Hematology (ASH) Friday Scientific Workshop entitled “Immune Profiling and Minimal Residual Disease Testing in Multiple Myeloma”. This workshop focused on four main topics: the molecular and immunological evolution of plasma cell disorders, the development of new laboratory- and imaging-based MRD assessment approaches, chimeric antigen receptor T-cell therapy research, and the statistical and regulatory issues associated with novel clinical endpoints. In this report, we provide a summary of the workshop and discuss future directions.