Cardiotoxicity of T cell immunotherapies

Area of Science:

• Oncology
• Immunology
• Cardiology

Background:

• T cell immunotherapies, including CAR T cell therapy, are novel cancer treatments.
• These therapies harness genetically engineered T cells to enhance anti-tumour responses.
• Emerging T cell therapies include bispecific antibodies, TCR-engineered T cells, and TILs.

Purpose of the Study:

• To review the mechanisms, epidemiology, and management of T cell therapy-associated cytokine release syndrome (CRS).
• To discuss the cardiovascular toxicities linked to T cell therapies.
• To explore how understanding these adverse events can improve patient care.

Main Methods:

• Literature review summarizing existing research on T cell therapies and cardiotoxicity.
• Analysis of mechanisms linking T cell activation, CRS, and cardiovascular complications.
• Epidemiological data on the incidence of cardiovascular events in high-grade CRS.

Main Results:

• T cell activation can trigger massive cytokine release (CRS), causing inflammation.
• CRS can lead to severe cardiovascular complications such as arrhythmias, myocardial infarction, and heart failure.
• Cardiovascular events occur in up to 20% of patients with high-grade CRS.

Conclusions:

• A comprehensive understanding of CRS and its cardiotoxic effects is essential as T cell therapies expand.
• Improved knowledge of CAR T cell therapy and other T cell treatments will guide the prevention and management of cardiovascular adverse events.
• Proactive management strategies are needed to mitigate the risks associated with T cell therapy-induced cardiotoxicity.