Borrega, Jorge Garcia, Goedel, Philipp, Rueger, Maria Adele, Onur, Oezguer A., Shimabukuro-Vornhagen, Alexander, Kochanek, Matthias and Boell, Boris (2019). In the Eye of the Storm: Immune-mediated Toxicities Associated With CAR-T Cell Therapy. Hemasphere, 3 (2). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 2572-9241

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Abstract

The success of chimeric antigen receptor (CAR)-T cell therapy with impressive response rates in hematologic malignancies but also promising data in solid tumors came along with the cognition of unexpected, potentially life-threatening immune-mediated toxicities, namely the cytokine release syndrome (CRS) and neurotoxicity recently referred to as immune effector cell-associated neurotoxicity syndrome (ICANS). These toxicities require urgent diagnostic and therapeutic interventions and targeted modulation of key cytokine pathways represents the mainstay of CRS treatment. However, as the underlying mechanisms of ICANS are not well understood, treatment options remain limited and further investigation is warranted. Importantly, after the recent market approval of 2 CAR-T cell constructs, the application of CAR-T cells will expand to nonacademic centers with limited experience in the management of CAR-T cell-associated toxicities. Here, we review the current evidence of CRS and ICANS pathophysiology, diagnostics, and treatment.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Borrega, Jorge GarciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goedel, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rueger, Maria AdeleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Onur, Oezguer A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shimabukuro-Vornhagen, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kochanek, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boell, BorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-151210
DOI: 10.1097/HS9.0000000000000191
Journal or Publication Title: Hemasphere
Volume: 3
Number: 2
Date: 2019
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 2572-9241
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CYTOKINE-RELEASE SYNDROME; MACROPHAGE ACTIVATION SYNDROME; CHRONIC LYMPHOCYTIC-LEUKEMIA; INTERNATIONAL CONSENSUS; MOLECULAR REMISSIONS; MANAGEMENT; TRIAL; IL-6; TRANSPLANTATION; IDENTIFICATIONMultiple languages
HematologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/15121

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