Researchers at the Icahn School of Medicine at Mount Sinai have demonstrated that wearable devices may enable earlier detection of cytokine release syndrome (CRS), a potentially serious complication of CAR-T cell therapy. The findings suggest that continuous monitoring through wearable technology could improve patient safety, support outpatient treatment models and reduce the need for lengthy hospital stays.
CAR-T therapy has emerged as an important treatment option for patients with relapsed or refractory multiple myeloma, a blood cancer originating in plasma cells within the bone marrow. By genetically engineering a patient's own immune cells to recognize and attack cancer cells, the therapy has delivered promising outcomes in patients with limited treatment options.
However, CAR-T treatment is associated with the risk of CRS, an inflammatory response triggered by an overactive immune system. Symptoms can range from fever and fatigue to low blood pressure, breathing difficulties and, in severe cases, life-threatening complications. As a result, patients often require intensive monitoring during the days following treatment.
Real-time patient monitoring
To investigate whether wearable technology could identify early signs of CRS, researchers conducted a prospective pilot study involving 30 patients receiving CAR-T therapy for multiple myeloma at The Mount Sinai Hospital. Participants were equipped with wearable sensors that continuously tracked skin and underarm temperature, heart rate, respiratory rate, oxygen saturation and physical activity. In parallel, researchers collected blood samples to measure cytokines—immune signaling proteins closely associated with inflammatory responses and CRS development.
Of the 30 participants, 25 were considered evaluable for analysis. Among these patients, the wearable monitoring platform detected 18 of 20 CRS episodes. Importantly, the system identified signs of toxicity a median of seven hours before they were recognized through standard nursing assessments. According to the research team, this earlier detection window could provide clinicians with valuable time to intervene before symptoms escalate. Such interventions may help reduce complications and improve the overall patient experience during recovery.
Linking biological markers to wearable data
Beyond detecting clinical symptoms, the study also examined whether wearable-generated data could be linked to biological indicators of inflammation. Researchers found a strong association between temperature changes recorded by the devices and levels of interferon gamma (IFN-γ), a cytokine involved in immune activation. The findings suggest that combining continuous physiological monitoring with biomarker analysis could pave the way for more sophisticated predictive models. Such models may eventually allow healthcare teams not only to detect CRS earlier but also to anticipate which patients are most likely to develop severe toxicity.
The researchers believe this integrated approach could contribute to more personalized care pathways for patients receiving advanced immunotherapies, enabling clinicians to tailor monitoring and intervention strategies based on individual risk profiles. One of the most significant implications of the study is its potential impact on care delivery. Current CAR-T treatment pathways often require patients to remain close to specialized cancer centers for observation, creating logistical and financial burdens for patients and healthcare systems alike.
Monitoring may transform CAR-T aftercare
If future studies confirm the results, wearable monitoring could support safer outpatient CAR-T programs, allowing more patients to recover at home or within community-based care settings. This could be particularly beneficial for individuals who live far from major oncology centers or in regions with limited access to specialized cancer care. The researchers caution that the study was relatively small and conducted at a single institution. Larger, multi-center studies will be required to validate the findings and determine how wearable monitoring performs in real-world outpatient settings.
Nevertheless, the results highlight the growing potential of digital health technologies to enhance cancer care. By combining wearable sensors with biological data, clinicians may gain new tools to detect treatment-related complications earlier, personalize care and improve outcomes for patients undergoing next-generation cancer therapies.
Accelerate immunotherapy
Last year, researchers developed a novel “tumor-on-a-chip” platform that offers an unprecedented view of how solid tumors evade immune system attacks. The transparent, microengineered device replicates a living, vascularized human lung tumor, allowing scientists to observe in real time how CAR T-cells interact with cancer cells and navigate the tumor microenvironment (TME), a protective ecosystem that often limits the effectiveness of immunotherapy.
Using the platform, researchers discovered that endothelial cells release short-lived chemical signals that guide CAR T-cells toward tumors. They identified the enzyme DPP4 as a key factor in breaking down these signals and found that vildagliptin, a diabetes drug that inhibits DPP4, helped more CAR T-cells reach and attack cancer cells. By combining multiomics analysis with advanced bioinformatics, the team uncovered new insights into tumor-immune interactions. The platform could accelerate immunotherapy development, support drug repurposing, reduce reliance on animal testing, and enable safer, more personalized cancer treatments.
References
JCI Insight (research)
