Living with multiple myeloma is a heavy burden, and while new CAR-T cell therapies offer hope, they can come with unexpected side effects. A large review of data from over 4,600 patients looked specifically at neurological problems that are not related to the common ICANS reaction. These issues, called non-ICANS neurologic toxicities (NINTs), can affect how a patient moves or feels.
The study compared different types of BCMA-directed CAR-T therapies. It found that while these nerve issues are rare overall, they were significantly more common in patients treated with ciltacabtagene autoleucel. Specifically, the rate was 4.6% for that treatment compared to only 0.5% for idecabtagene vicleucel. The most frequent type of nerve issue reported was cranial nerve palsies, which occurred in about 32 percent of cases.
Because these side effects are rare but important, researchers note that more standardized reporting is needed. While the data shows a clear difference between certain treatments, there is still limited information on exactly why some patients develop these issues or what specific risk factors lead to them. Patients should discuss these specific risks with their doctors to understand the best path forward.
