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应对嵌合抗原受体T细胞毒性的不断演变的策略。

Evolving strategies for addressing CAR T-cell toxicities.

作者信息

Rankin Alexander W, Duncan Brynn B, Allen Cecily, Silbert Sara K, Shah Nirali N

机构信息

Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.

Division of Hematology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Cancer Metastasis Rev. 2024 Dec 15;44(1):17. doi: 10.1007/s10555-024-10227-1.

Abstract

The field of chimeric antigen receptor (CAR) T-cell therapy has grown from a fully experimental concept to now boasting a multitude of treatments including six FDA-approved products targeting various hematologic malignancies. Yet, along with their efficacy, these therapies come with side effects requiring timely and thoughtful interventions. In this review, we discuss the most common toxicities associated with CAR T-cells to date, highlighting risk factors, prognostication, implications for critical care management, patient experience optimization, and ongoing work in the field of toxicity mitigation. Understanding the current state of the field and standards of practice is critical in order to improve and manage potential toxicities of both current and novel CAR T-cell therapies as they are applied in the clinic.

摘要

嵌合抗原受体(CAR)T细胞疗法领域已从一个完全实验性的概念发展到如今拥有多种治疗方法,包括六种获得美国食品药品监督管理局(FDA)批准、针对各种血液系统恶性肿瘤的产品。然而,这些疗法在发挥疗效的同时,也伴随着副作用,需要及时且周到的干预措施。在本综述中,我们讨论了迄今为止与CAR T细胞相关的最常见毒性,重点介绍了风险因素、预后判断、对重症监护管理的影响、患者体验优化以及毒性缓解领域的正在进行的工作。了解该领域的当前状况和实践标准对于改善和管理当前及新型CAR T细胞疗法在临床应用中的潜在毒性至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7652/11646216/7987905990b1/10555_2024_10227_Fig1_HTML.jpg

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