Ye Kexin, Yu Chaohui, Shen Zhe
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, China.
Ther Adv Med Oncol. 2024 Dec 23;16:17588359241309825. doi: 10.1177/17588359241309825. eCollection 2024.
Chimeric antigen receptor T (CAR T) cells have shown their potential in hematological malignancies and the treatment of solid tumors, especially in metastases. However, CAR T-cell therapy may carry risks of inducing severe adverse effects, which are recognized as immune-related adverse events. Here, we report two cases of severe colitis presented with refractory bloody diarrhea, which were induced by carcinoembryonic antigen (CEA)-directed CAR T therapy in the treatment of metastatic colorectal adenocarcinoma. These patients were treated as part of a clinical trial. The clinical trial was registered at ClinicalTrials.gov (NCT05396300), submitted, and started on May 25, 2022. Glucocorticoids combined with vedolizumab were used to control their gastrointestinal symptoms but the outcomes were unsatisfactory. This report highlights the potentially serious risks of anti-CEA CAR T therapy and provides management options.
嵌合抗原受体T（CAR T）细胞已在血液系统恶性肿瘤及实体瘤治疗中展现出潜力，尤其是在转移瘤治疗方面。然而，CAR T细胞疗法可能存在引发严重不良反应的风险，这些不良反应被视为免疫相关不良事件。在此，我们报告两例严重结肠炎病例，表现为难治性血性腹泻，由癌胚抗原（CEA）导向的CAR T疗法在转移性结直肠癌治疗中诱发。这些患者作为一项临床试验的一部分接受治疗。该临床试验已在ClinicalTrials.gov（NCT05396300）注册、提交，并于2022年5月25日启动。使用糖皮质激素联合维多珠单抗来控制他们的胃肠道症状，但效果并不理想。本报告强调了抗CEA CAR T疗法潜在的严重风险，并提供了管理方案。
