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Cytokine release syndrome in solid tumors.

David Synnott1,2,3, David O'Reilly1,3,4, Declan De Freitas1,2,4

  • 1Beaumont Hospital, Dublin, Ireland.

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|August 23, 2025
PubMed
Summary

Cytokine release syndrome (CRS) is a serious immunotherapy side effect. This review details CRS in solid tumors, focusing on unique challenges and management strategies for better patient outcomes.

Keywords:
adoptivechimeric antigen receptor therapycytokine release syndromedrug‐related side effects and adverse reactionsimmune checkpoint inhibitorsimmunotherapysolid tumors

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Area of Science:

  • Oncology
  • Immunology
  • Pharmacology

Background:

  • Cytokine release syndrome (CRS) is a frequent complication of cancer immunotherapies like CAR T-cell therapies and bispecific T-cell engagers.
  • Current management guidelines for CRS primarily address hematological malignancies, necessitating specific considerations for solid tumors.

Purpose of the Study:

  • To review the pathophysiology, clinical presentation, and management of CRS in the context of solid organ tumors.
  • To highlight the unique challenges and complexities of CRS in solid tumors, including the tumor microenvironment and potential toxicities.

Main Methods:

  • Literature review of existing research on CRS in solid tumors.
  • Analysis of pathophysiology, clinical manifestations, and current therapeutic strategies.
  • Discussion of emerging treatments and future research directions.

Main Results:

  • Solid tumors present unique CRS challenges due to immunosuppressive microenvironments and potential on-target, off-tumor effects.
  • Early detection and grading are crucial for effective CRS management.
  • Management ranges from supportive care for mild cases to targeted therapies (e.g., tocilizumab, corticosteroids) and ICU support for severe cases.

Conclusions:

  • Personalized treatment approaches are needed to enhance immunotherapy safety and efficacy in solid tumor patients experiencing CRS.
  • Further research into risk stratification, novel therapies, and long-term outcomes is essential.
  • Understanding CRS in solid tumors will improve patient care and treatment strategies.