Artikel ; Online: Management and Prevention of Cellular-Therapy-Related Toxicity: Early and Late Complications.
Current oncology (Toronto, Ont.)
2023 Band 30, Heft 5, Seite(n) 5003–5023
Abstract: Chimeric Antigen Receptor T (CAR-T) cell therapy has dramatically changed prognosis and treatment of relapsed and refractory hematologic malignancies. Currently the 6 FDA approved products target various surface antigens. While CAR-T therapy achieves ... ...
| Abstract | Chimeric Antigen Receptor T (CAR-T) cell therapy has dramatically changed prognosis and treatment of relapsed and refractory hematologic malignancies. Currently the 6 FDA approved products target various surface antigens. While CAR-T therapy achieves good response, life-threatening toxicities have been reported. Mechanistically, can be divided into two categories: (1) toxicities related to T-cell activation and release of high levels of cytokines: or (2) toxicities resulting from interaction between CAR and CAR targeted antigen expressed on non-malignant cells (i.e., on-target, off-tumor effects). Variations in conditioning therapies, co-stimulatory domains, CAR T-cell dose and anti-cytokine administration, pose a challenge in distinguishing cytokine mediated related toxicities from on-target, off-tumor toxicities. Timing, frequency, severity, as well as optimal management of CAR T-cell-related toxicities vary significantly between products and are likely to change as newer therapies become available. Currently the FDA approved CARs are targeted towards the B-cell malignancies however the future holds promise of expanding the target to solid tumor malignancies. Further highlighting the importance of early recognition and intervention for early and late onset CAR-T related toxicity. This contemporary review aims to describe presentation, grading and management of commonly encountered toxicities, short- and long-term complications, discuss preventive strategies and resource utilization. |
|---|---|
| Mesh-Begriff(e) | Humans ; Receptors, Chimeric Antigen/therapeutic use ; Receptors, Antigen, T-Cell/metabolism ; T-Lymphocytes ; Treatment Outcome ; Neoplasms/drug therapy |
| Chemische Substanzen | Receptors, Chimeric Antigen ; Receptors, Antigen, T-Cell |
| Sprache | Englisch |
| Erscheinungsdatum | 2023-05-15 |
| Erscheinungsland | Switzerland |
| Dokumenttyp | Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural |
| ZDB-ID | 1236972-x |
| ISSN | 1718-7729 ; 1198-0052 |
| ISSN (online) | 1718-7729 |
| ISSN | 1198-0052 |
| DOI | 10.3390/curroncol30050378 |
| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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