嵌合抗原受体
医学
细胞因子释放综合征
免疫学
T细胞
细胞毒性T细胞
细胞
癌症研究
免疫系统
细胞疗法
内科学
生物
遗传学
生物化学
体外
作者
Maria‐Luisa Schubert,Michael Schmitt,L. Wang,Carlos A. Ramos,Karin Jordan,Carsten Müller‐Tidow,Peter Dreger
标识
DOI:10.1016/j.annonc.2020.10.478
摘要
•CAR T cells are associated with unique side-effects.•Cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS) and cytopenias are common.•Understanding the presentation, pathophysiology, grading and management of side-effects is crucial for CAR T-cell safety. Chimeric antigen receptor (CAR) T cells directed against the B-cell marker CD19 are currently changing the landscape for treatment of patients with refractory and/or relapsed B-cell malignancies. Due to the nature of CAR T cells as living drugs, they display a unique toxicity profile. As CAR T-cell therapy is extending towards other diseases and being more broadly employed in hematology and oncology, optimal management strategies of side-effects associated with CAR T-cell therapy are of high relevance. Cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and cytopenias constitute challenges in the treatment of patients with CAR T cells. This review summarizes the current understanding of CAR T-cell toxicity and its management. Chimeric antigen receptor (CAR) T cells directed against the B-cell marker CD19 are currently changing the landscape for treatment of patients with refractory and/or relapsed B-cell malignancies. Due to the nature of CAR T cells as living drugs, they display a unique toxicity profile. As CAR T-cell therapy is extending towards other diseases and being more broadly employed in hematology and oncology, optimal management strategies of side-effects associated with CAR T-cell therapy are of high relevance. Cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and cytopenias constitute challenges in the treatment of patients with CAR T cells. This review summarizes the current understanding of CAR T-cell toxicity and its management.
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