A polyamine-centric, blood-based metabolite panel predictive of poor response to CAR-T cell therapy in large B cell lymphoma

Johannes F. Fahrmann, Neeraj Y. Saini, Chang Chia-Chi, Ehsan Irajizad, Paolo Strati, Ranjit Nair, Luis E. Fayad, Sairah Ahmed, Hun Ju Lee, Swaminathan Iyer, Raphael Steiner, Jody Vykoukal, Ranran Wu, Jennifer B. Dennison, Loretta Nastoupil, Preetesh Jain, Michael Wang, Michael Green, Jason Westin, Viktoria BlumenbergMarco Davila, Richard Champlin, Elizabeth J. Shpall, Partow Kebriaei, Christopher R. Flowers, Michael Jain, Robert Jenq, Christoph K. Stein-Thoeringer, Marion Subklewe, Sattva S. Neelapu, Sam Hanash

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Anti-CD19 chimeric antigen receptor (CAR) T cell therapy for relapsed or refractory (r/r) large B cell lymphoma (LBCL) results in durable response in only a subset of patients. MYC overexpression in LBCL tumors is associated with poor response to treatment. We tested whether an MYC-driven polyamine signature, as a liquid biopsy, is predictive of response to anti-CD19 CAR-T therapy in patients with r/r LBCL. Elevated plasma acetylated polyamines were associated with non-durable response. Concordantly, increased expression of spermidine synthase, a key enzyme that regulates levels of acetylated spermidine, was prognostic for survival in r/r LBCL. A broad metabolite screen identified additional markers that resulted in a 6-marker panel (6MetP) consisting of acetylspermidine, diacetylspermidine, and lysophospholipids, which was validated in an independent set from another institution as predictive of non-durable response to CAR-T therapy. A polyamine centric metabolomics liquid biopsy panel has predictive value for response to CAR-T therapy in r/r LBCL.

Original languageEnglish (US)
Article number100720
JournalCell Reports Medicine
Volume3
Issue number11
DOIs
StatePublished - Nov 15 2022

Keywords

  • CAR-T cell therapy
  • biomarker
  • large B cell lymphoma
  • liquid biopsy
  • metabolites
  • prognostic

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology

MD Anderson CCSG core facilities

  • Biostatistics Resource Group
  • Tissue Biospecimen and Pathology Resource
  • Microbiome Facility

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