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Bue Ross Agner1, Caroline Hasselbalch Riley2, Søren Lykke Petersen2

  • 1Afdeling for Kræftbehandling, Københavns Universitetshospital - Rigshospitalet.

Ugeskrift for Laeger
|March 6, 2024
PubMed
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Chimeric antigen T-cell therapy (CAR-T) and T-cell engagers can cause cytokine release syndrome (CRS), a serious inflammatory condition. This review discusses managing CRS with supportive and immunosuppressive treatments, and mitigating risks through dosing strategies and pre-treatment.

Area of Science:

  • Oncology
  • Immunology
  • Pharmacology

Background:

  • T-cell-based immunotherapies, including CAR-T therapy, are increasingly used for hematological malignancies and being explored for solid tumors.
  • Cytokine release syndrome (CRS) is a frequent, potentially life-threatening side effect of CAR-T and T-cell engager therapies, marked by systemic inflammation.
  • CRS management parallels that of other hyper-inflammatory conditions, requiring supportive care and immunosuppression.

Conclusions:

  • Cytokine release syndrome is a critical safety consideration in T-cell immunotherapy.
  • Risk mitigation strategies, including optimized dosing and immunosuppressive pre-treatment, are crucial for patient safety.
  • A comprehensive approach combining supportive care, immunosuppression, and risk management is essential for managing CRS.

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