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Tumor Immunotherapy

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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Evolving strategies for addressing CAR T-cell toxicities.

Alexander W Rankin1, Brynn B Duncan1, Cecily Allen2,3

  • 1Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.

Cancer Metastasis Reviews
|December 14, 2024
PubMed
Summary

Chimeric antigen receptor (CAR) T-cell therapy offers effective cancer treatments but can cause side effects. This review details common CAR T-cell toxicities, management strategies, and future directions for mitigation.

Keywords:
B-cell acute lymphoblastic leukemiaB-cell lymphomaCAR T-cellRelapseResistance

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Area of Science:

  • Immunotherapy
  • Oncology
  • Cellular Therapy

Background:

  • Chimeric antigen receptor (CAR) T-cell therapy has evolved into a significant treatment modality for hematologic malignancies.
  • Six CAR T-cell products are currently FDA-approved, demonstrating clinical efficacy.
  • CAR T-cell therapy is associated with significant toxicities that necessitate careful management.

Purpose of the Study:

  • To review the most common toxicities associated with CAR T-cell therapy.
  • To highlight risk factors, prognostication, and critical care management implications.
  • To discuss patient experience optimization and ongoing efforts in toxicity mitigation.

Main Methods:

  • Literature review of common CAR T-cell toxicities.
  • Analysis of risk factors and prognostication strategies.
  • Discussion of clinical management and patient care.

Main Results:

  • Common toxicities of CAR T-cell therapy are identified.
  • Key risk factors and prognostic indicators are presented.
  • Strategies for critical care and patient experience are outlined.

Conclusions:

  • Understanding CAR T-cell toxicities is crucial for effective clinical application.
  • Management of toxicities requires timely and thoughtful interventions.
  • Ongoing research aims to mitigate adverse events and improve patient outcomes.