Cardiovascular Toxicities with Chimeric Antigen Receptor T-cell Therapy

Area of Science:

• Oncology
• Immunotherapy
• Cardiology

Background:

• Chimeric antigen receptor (CAR) T-cell therapy offers significant efficacy for refractory hematological malignancies.
• CAR T-cell therapy is associated with severe toxicities, primarily cytokine release syndrome (CRS).
• Cardiovascular manifestations of CRS are a critical concern, impacting patient outcomes.

Approach:

• This review synthesizes data from clinical trials and observational studies on CAR T-cell therapy-associated cardiotoxicity.
• It summarizes current treatment strategies for CRS and its cardiovascular sequelae.
• Surveillance protocols and future research directions for managing cardiotoxicity are explored.

Key Points:

• Cardiovascular toxicities of CRS include hypotension, arrhythmias, and left ventricular dysfunction.
• Cardiotoxicity may be transient in younger patients but potentially fatal in older adults with cardiac risk factors.
• Long-term cardiotoxicity data and standardized monitoring guidelines are currently limited.

Conclusions:

• Understanding and managing CAR T-cell-induced cardiotoxicity is crucial for patient safety.
• Further research is needed to define long-term effects and establish robust surveillance and prevention strategies.
• This review provides a comprehensive overview to guide clinical practice and future investigations in CAR T-cell therapy.