Ferreros Puri, Trapero Isabel
Nursing Department, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain.
Diseases. 2022 Jul 6;10(3):41. doi: 10.3390/diseases10030041.
Chimeric antigen receptor T-cell (CAR-T) therapy is an innovative therapeutic option for addressing certain recurrent or refractory hematological malignancies. However, CAR-T cells also cause the release of pro-inflammatory cytokines that lead to life-threatening cytokine release syndrome and neurotoxicity.
To study the efficacy of interleukin inhibitors in addressing cytokine release syndrome (CRS) and neurotoxicity secondary to CAR-T therapy.
The authors conducted a bibliographic review in which 10 articles were analyzed. These included cut-off studies, case reports, and clinical trials involving 11 cancer centers and up to 475 patients over 18 years of age.
Tocilizumab is the only interleukin inhibitor approved to address CRS secondary to CAR-T therapy due to its efficacy and safety. Other inhibitors, such as siltuximab and anakinra, could be useful in combination with tocilizumab for preventing severe cytokine release and neurotoxicity. In addition, the new specific inhibitors could be effective in mitigating CRS without affecting the cytotoxic efficacy of CAR-T therapy.
More lines of research should be opened to elucidate the true implications of these drugs in treating the side effects of CAR-T therapy.
嵌合抗原受体T细胞（CAR-T）疗法是治疗某些复发或难治性血液系统恶性肿瘤的一种创新治疗选择。然而，CAR-T细胞也会导致促炎细胞因子的释放，从而引发危及生命的细胞因子释放综合征和神经毒性。
研究白细胞介素抑制剂在治疗CAR-T疗法继发的细胞因子释放综合征（CRS）和神经毒性方面的疗效。
作者进行了一项文献综述，分析了10篇文章。这些文章包括截止研究、病例报告以及涉及11个癌症中心和多达475名18岁以上患者的临床试验。
托珠单抗因其疗效和安全性，是唯一被批准用于治疗CAR-T疗法继发CRS的白细胞介素抑制剂。其他抑制剂，如西妥昔单抗和阿那白滞素，可与托珠单抗联合使用，以预防严重的细胞因子释放和神经毒性。此外，新型特异性抑制剂可能在减轻CRS方面有效，而不影响CAR-T疗法的细胞毒性疗效。
应开展更多研究方向，以阐明这些药物在治疗CAR-T疗法副作用方面的真正意义。
