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.
Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
Read More
Government agencies have created an online portal for the public to report potential anticompetitive practices in health care; there are changes coming to the “boxed warning” section for chimeric antigen receptor T-cell therapies (CAR T) to highlight T-cell blood cancer risk; questions about the safety of obesity medications during pregnancy have arisen in women on them who previously struggled with fertility issues.
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
Gene, Light Therapy Combo Shows Promise Against Prostate Cancer Cells in Proof-of-Concept Study
April 18th 2024In their preclinical model, the researchers found efficacy both in vitro and in vivo by using CRISPR-Cas9 to mimic porphyria and combining the technology with light therapy.
Read More
Pegcetacoplan for PNH More Cost-Effective Than Anti-C5 Monoclonal Antibodies
April 18th 2024A cost-utility analysis conducted from the perspective of the Italian health system found that pegcetacoplan was more effective and less costly than 2 complement 5 (C5) inhibitors for the treatment of paroxysmal nocturnal hemoglobinuria (PNH).
Read More