Adverse events associated with chimeric antigen receptor T-cell therapy in ophthalmology: a narrative review
Sara Sarwar1, Unood Riaz1, Abraish Ali1
1Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Abstract:
Chimeric antigen receptors are synthetically produced receptors engineered to engage with target cells with high specificity. These cells are created by inserting an artificial T-cell receptor into an immunoglobulin's antigen-binding region, allowing the cells to combine and target specific antigens. The use of chimeric antigen receptor (CAR) T-cell therapy has been a remarkable achievement in the field of immunotherapy, particularly in the treatment of ophthalmic tumors like retinoblastoma and uveal melanoma. However, there are some documented side effects, such as cytokine release syndrome (CRS) and immunological effector cell-associated neurotoxicity syndrome (ICANS). Additionally, ocular side effects such as blurred vision, vision impairment, and intraocular infections are also concerning and require further evaluation. This review highlights the advances made in chimeric antigen receptor (CAR) immunotherapy, including its structure and manufacture, as well as relevant clinical discoveries and associated adverse effects. By identifying the gaps in current research, this analysis provides insights into potential strategies and solutions for addressing some of the most severe side effects.
Insights
Chimeric antigen receptor (CAR) T-cell therapy shows promise for ophthalmic tumors but has side effects. This review explores CAR immunotherapy advances, clinical findings, and strategies to mitigate adverse events.
Area of Science:
- Immunotherapy
- Oncology
- Ophthalmology
Background:
- Chimeric antigen receptors (CARs) are engineered receptors for targeted cell engagement.
- CAR T-cell therapy is a significant advancement in immunotherapy, especially for ophthalmic tumors like retinoblastoma and uveal melanoma.
Purpose of the Study:
- To review advances in CAR immunotherapy, including structure, manufacturing, and clinical applications.
- To identify and analyze adverse effects associated with CAR T-cell therapy.
- To explore potential strategies for managing severe side effects.
Main Methods:
- Literature review of CAR immunotherapy.
- Analysis of clinical discoveries and associated adverse events.
- Identification of research gaps and potential solutions.
Main Results:
- CAR T-cell therapy demonstrates efficacy in treating ophthalmic tumors.
- Documented side effects include cytokine release syndrome (CRS), neurotoxicity (ICANS), and ocular issues (blurred vision, infections).
Conclusions:
- CAR immunotherapy offers a promising therapeutic avenue for ophthalmic malignancies.
- Managing side effects like CRS, ICANS, and ocular complications is crucial for patient safety and treatment success.
- Further research is needed to address and mitigate the severe adverse effects of CAR T-cell therapy.
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