Physicians across different institutes who have been involved in clinical trials of chimeric antigen receptor (CAR) T cells in B-cell lymphomas have developed a guideline for monitoring and managing the symptoms associated with this treatment.
Cytokine release syndrome (CRS) and chimeric antigen receptor (CAR) T cell—related encephalopathy syndrome (CRES) are significant side effects that are not commonly encountered when patients are treated with anticancer agents; however, these are a common phenomenon among patients treated with CAR T-cell therapies. Now, physicians across different institutes who have been involved in clinical trials of CAR T cells in B-cell lymphomas have developed a guideline for managing CRS and CRES.
The review is based on the experiences gained when treating over 100 patients who received care at MD Anderson Cancer Center at the University of Texas, Moffitt Cancer Center in Tampa, Sylvester Cancer Center at the University of Miami, and Mayo Clinic Cancer Center in Rochester, Minneapolis.
Following is an overview of some of the recommendations:
The authors have also developed a 3-step flowchart for easier assessment and management of acute toxicities with this treatment, as well as concise tables for identifying and managing different grades of CRS and CRES.
“This represents a sea change in how we treat these patients,” said lead author Sattva Neelapu, MD, professor of Lymphoma and Multiple Myeloma at MD Anderson, in a statement. “There have been no new treatments approved for patients with aggressive B-cell lymphomas relapsing after first line therapy in 30 years, and only about 10% survive long term.”
Highlighting that CAR T-cell infusions are potentially curative, Nellapu added, “The toxicities are unique, and every member of the care team needs to be trained to recognize them and act accordingly.”
Reference
Neelapu SS, Tummala S, Kebriaei P, et al. Chimeric antigen receptor T-cell therapy - assessment and management of toxicities. Nat Rev Clin Oncol. 2017. doi: 10.1038/nrclinonc.2017.148.
Data Back Neoadjuvant Combo vs Chemo Alone for Early-Stage NSCLC
April 24th 2024For patients with early-stage non–small cell lung cancer (NSCLC), combining neoadjuvant immune checkpoint inhibitors and platinum-based chemotherapy improves 2-year outcomes over chemotherapy alone, suggest findings of an extensive literature review and meta-analysis.
Read More
Oncology Onward: A Conversation With Penn Medicine's Dr Justin Bekelman
December 19th 2023Justin Bekelman, MD, director of the Penn Center for Cancer Care Innovation, sat with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, for our final episode of 2023 to discuss the importance of collaboration between academic medicine and community oncology and testing innovative cancer care delivery in these settings.
Listen
Polatuzumab Vedotin and R-CHP Appropriate for Untreated DLBCL
April 24th 2024Population pharmacokinetic and exposure-response analyses revealed a favorable benefit-risk profilane for the treatment combination of polatuzumab vedotin and rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP).
Read More