文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

肿瘤患者接受CAR-T疗法相关常见毒性的缓解与管理

Mitigation and Management of Common Toxicities Associated with the Administration of CAR-T Therapies in Oncology Patients.

作者信息

Renninger Jonathan, Kurz Lisa, Stein Heather

机构信息

GSK Safety Evaluation and Risk Management, Global Safety, Philadelphia, PA, USA.

GSK Safety Evaluation and Risk Management, Global Safety, Upper Providence, PA, USA.

出版信息

Drug Saf. 2025 Mar 19. doi: 10.1007/s40264-025-01538-5.


DOI:10.1007/s40264-025-01538-5
PMID:40108072
Abstract

Chimeric antigen receptor T-cell (CAR-T) therapies are one of the main approaches among targeted cellular therapies. Despite the potential benefit and durable responses observed in some patients receiving CAR-T therapies, serious and potentially fatal toxicities remain a major challenge. The most common CAR-T-associated toxicities include cytokine release syndrome (CRS), neurotoxicity, cytopenias, and infections. While CRS and neurotoxicity are generally managed with tocilizumab and corticosteroids, respectively, high-grade toxicities can be life-threatening. Close postinfusion monitoring and assessment of clinical laboratory parameters, patient-related and clinical risk factors (e.g., age, tumor burden, comorbidities, baseline laboratory parameters, and underlying abnormalities), and therapy-related risk factors (e.g., CAR-T type, dose, and CAR-T-induced toxicity) are effective strategies to mitigate the toxicities. Clinical laboratory parameters, including various cytokines, have been identified for CRS (interleukin [IL]-1, IL-2, IL-5, IL-6, IL-8, IL-10, C-reactive protein [CRP], interferon [IFN]-γ, ferritin, granulocyte-macrophage colony-stimulating factor [GM-CSF], and monocyte chemoattractant protein-1), neurotoxicity (IL-1, IL-2, IL-6, IL-15, tumor necrosis factor [TNF]-α, GM-CSF, and IFN-γ), cytopenias (IL-2, IL-4, IL-6, IL-10, IFN-γ, ferritin, and CRP), and infections (IL-8, IL-1β, CRP, IFN-γ, and procalcitonin). CAR-T-associated toxicities can be monitored and treated to mitigate the risk to patients. Assessment of alterations in clinical laboratory parameter values that are correlated with CAR-T-associated toxicities may predict development and/or severity of a given toxicity, which can improve patient management strategies and ultimately enable the patients to better tolerate these therapies.

摘要

嵌合抗原受体T细胞(CAR-T)疗法是靶向细胞疗法的主要方法之一。尽管在一些接受CAR-T疗法的患者中观察到了潜在益处和持久反应,但严重且可能致命的毒性仍然是一个重大挑战。最常见的与CAR-T相关的毒性包括细胞因子释放综合征(CRS)、神经毒性、血细胞减少和感染。虽然CRS和神经毒性通常分别用托珠单抗和皮质类固醇进行处理,但高级别毒性可能危及生命。输注后密切监测和评估临床实验室参数、患者相关和临床风险因素(如年龄、肿瘤负荷、合并症、基线实验室参数和潜在异常)以及治疗相关风险因素(如CAR-T类型、剂量和CAR-T诱导的毒性)是减轻毒性的有效策略。临床实验室参数,包括各种细胞因子,已被确定与CRS(白细胞介素[IL]-1、IL-2、IL-5、IL-6、IL-8、IL-10、C反应蛋白[CRP]、干扰素[IFN]-γ、铁蛋白、粒细胞-巨噬细胞集落刺激因子[GM-CSF]和单核细胞趋化蛋白-1)、神经毒性(IL-1、IL-2、IL-6、IL-15、肿瘤坏死因子[TNF]-α、GM-CSF和IFN-γ)、血细胞减少(IL-2、IL-4、IL-6、IL-10、IFN-γ、铁蛋白和CRP)以及感染(IL-8、IL-1β、CRP、IFN-γ和降钙素原)相关。与CAR-T相关的毒性可以进行监测和治疗,以降低对患者的风险。评估与CAR-T相关毒性相关的临床实验室参数值的变化可能预测特定毒性的发生和/或严重程度,这可以改善患者管理策略,并最终使患者能够更好地耐受这些疗法。

相似文献

[1]
Mitigation and Management of Common Toxicities Associated with the Administration of CAR-T Therapies in Oncology Patients.

Drug Saf. 2025-3-19

[2]
Assessing the comparative effects of interventions in COPD: a tutorial on network meta-analysis for clinicians.

Respir Res. 2024-12-21

[3]
Low Peripheral Blood Counts and Elevated Proinflammatory Cytokines Signal a Poor CD19 Chimeric Antigen Receptor T-cell Response in Acute Lymphoblastic Leukemia.

Transplant Cell Ther. 2025-5-20

[4]
B cell antigens: A key to optimizing CAR-T cell therapy.

Int Rev Immunol. 2025-6-19

[5]
Adapting Safety Plans for Autistic Adults with Involvement from the Autism Community.

Autism Adulthood. 2025-5-28

[6]
Molecular feature-based classification of retroperitoneal liposarcoma: a prospective cohort study.

Elife. 2025-5-23

[7]
Community views on mass drug administration for soil-transmitted helminths: a qualitative evidence synthesis.

Cochrane Database Syst Rev. 2025-6-20

[8]
"Just Ask What Support We Need": Autistic Adults' Feedback on Social Skills Training.

Autism Adulthood. 2025-5-28

[9]
Stigma Management Strategies of Autistic Social Media Users.

Autism Adulthood. 2025-5-28

[10]
Surveillance for Violent Deaths - National Violent Death Reporting System, 50 States, the District of Columbia, and Puerto Rico, 2022.

MMWR Surveill Summ. 2025-6-12

引用本文的文献

[1]
Health-Related Values Discussions With Patients Receiving Allogeneic and Autologous Stem Cell Transplant and Chimeric Antigen Receptor Therapy (CAR-T): Implementation of an Early Nurse Practitioner-Led Primary Palliative Care Intervention.

J Hosp Palliat Nurs. 2025-8-22

本文引用的文献

[1]
Immune-Related Adverse Events Induced by Immune Checkpoint Inhibitors and CAR-T Cell Therapy: A Comprehensive Imaging-Based Review.

Cancers (Basel). 2024-7-19

[2]
FDA Adds Boxed Warning to CAR T-Cell Therapies, but Says Benefits Outweigh Risks of Secondary Cancers.

JAMA. 2024-3-12

[3]
CAR-T cell therapeutic avenue for fighting cardiac fibrosis: Roadblocks and perspectives.

Cell Biochem Funct. 2024-3

[4]
T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy.

Nat Med. 2024-4

[5]
Secondary Cancers after Chimeric Antigen Receptor T-Cell Therapy.

N Engl J Med. 2024-2-15

[6]
Unanswered questions following reports of secondary malignancies after CAR-T cell therapy.

Nat Med. 2024-2

[7]
Lymphodepletion - an essential but undervalued part of the chimeric antigen receptor T-cell therapy cycle.

Front Immunol. 2023

[8]
Prophylactic tocilizumab to prevent cytokine release syndrome (CRS) with teclistamab: A single-center experience.

Blood Cancer J. 2023-12-20

[9]
Population-Based External Validation of the EASIX Scores to Predict CAR T-Cell-Related Toxicities.

Cancers (Basel). 2023-11-16

[10]
Tisagenlecleucel utilisation and outcomes across refractory, first relapse and multiply relapsed B-cell acute lymphoblastic leukemia: a retrospective analysis of real-world patterns.

EClinicalMedicine. 2023-10-26

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索