CSF biomarkers reveal CNS immune effects of CAR T-cell therapy in MS: Phase I trial insights
Jeffrey Dunn, MD, Stanford University School of Medicine, Palo Alto, CA, discusses insights from cerebrospinal fluid (CSF) analysis in the Phase I trial (NCT06138132) investigating CAR T-cell therapy in multiple sclerosis (MS). Prof. Dunn highlights changes in oligoclonal bands and CSF free kappa light chains following CAR T-cell therapy, suggesting a measurable immunologic effect within the central nervous system (CNS). This interview took place at the 8th International Workshop on CAR-T and Bispecifics 2026, in Tampa, FL.
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Transcript
One of the things that we looked at was the presence of oligoclonal bands in the cerebrospinal fluid, and that’s a hallmark of multiple sclerosis. Those bands are there as antibodies that are recognizing something foreign. You don’t see antibodies in the spinal fluid of a patient without disease, so they’re there for a reason. And I want to call out and just salute the patients who have volunteered to step forward to do these studies, because one of the requirements in the trial that we’re running is for them to do four lumbar punctures in a year’s time, that we can be able to analyze their CSF, their cerebrospinal fluid, over the course of the year, that’s a really remarkable contribution to the field...
One of the things that we looked at was the presence of oligoclonal bands in the cerebrospinal fluid, and that’s a hallmark of multiple sclerosis. Those bands are there as antibodies that are recognizing something foreign. You don’t see antibodies in the spinal fluid of a patient without disease, so they’re there for a reason. And I want to call out and just salute the patients who have volunteered to step forward to do these studies, because one of the requirements in the trial that we’re running is for them to do four lumbar punctures in a year’s time, that we can be able to analyze their CSF, their cerebrospinal fluid, over the course of the year, that’s a really remarkable contribution to the field. And I think sometimes volunteering patients and research subjects don’t get enough credit for their bravery and for their selflessness in doing that. But being able to analyze CSF both at baseline and then after treatment has allowed us to see evidence of an immunologic impact within the central nervous system in which we’re seeing a down-regulation of oligoclonal bands or antibody fragments that are called CSF-free kappa light chains. And I think that really speaks to the fact that CAR-T therapy is getting into the central nervous system, which makes it unique and very valuable for MS care, and that it’s having a measurable immunologic impact. I think that’s an important key that we’re on the right track.
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