Chimeric Antigen Receptor T-cell Therapy Toxicities.

Chimeric Antigen Receptor T-cell Therapy Toxicities. Br J Clin Pharmacol. 2020 May 28;: Authors: Greenbaum U, Kebriaei P, Srour SA, Olson A, Bashir Q, Neelapu SS, Rezvani K, Shpall EJ Abstract Cancer immunotherapy has greatly advanced in recent years, with chimeric antigen receptor (CAR) T-cells emerging as an innovative technology that harnesses the immune system to fight malignant diseases. These genetically engineered T-cells have shown encouraging results for B-cell lymphoid malignancies and are now being explored for other cancer types. However, this novel adoptive cell therapy is associated with a new spectrum of immune-mediated adverse events and toxicities. As CAR-T cells recognize and engage tumor cells, cytokines are secreted and activate other immune cells, frequently leading to rapid development of cytokine release syndrome (CRS) which can result in acute deterioration of the patient's clinical condition. In many patients, CRS is mild and easy to manage, but others experience persistent fevers accompanied by hypotension and hypoxia which require management with immune-modulatory agents. Another deleterious effect of cytokines released by effector cells is immune effector cell-associated neurotoxicity syndrome (ICANS). This syndrome, caused by a disruption of the blood-brain barrier as a consequence of the immune process, can result in rapid deterioration in cognitive function. This is often associated with subtle changes ...
Source: Clinical Lymphoma and Myeloma - Category: Cancer & Oncology Authors: Tags: Br J Clin Pharmacol Source Type: research