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嵌合抗原受体T细胞疗法相关的心血管毒性

Cardiovascular toxicities associated with chimeric antigen receptor T-cell therapy.

作者信息

Liu Jia-Hui, Liu Kun-Yao, Zhao Xiang, Zhou Xin, Jiang Yichuan

机构信息

Cancer Center, The First Hospital of Jilin University, Changchun, China.

Cancer Research Institute of Jilin University, The First Hospital of Jilin University, Changchun, China.

出版信息

Front Pharmacol. 2025 May 8;16:1578157. doi: 10.3389/fphar.2025.1578157. eCollection 2025.

Abstract

Chimeric antigen receptor (CAR) T-cell therapy has emerged as a groundbreaking immunotherapeutic approach, particularly for oncohematological patients who are refractory to conventional treatments. As clinical trials expand the applications of CAR T-cell therapy beyond hematologic malignancies, a critical understanding of its associated toxicities, particularly cardiovascular complications, becomes imperative. This review synthesizes current literature on the interplay between cytokine release syndrome (CRS) and cardiotoxicity related to CAR T-cell therapy, emphasizing the potential severity of these adverse events. While significant progress has been made in managing CRS, the cardiac manifestations-ranging from mild events to life-threatening complications-remain underreported in pivotal studies. We explore the incidence and nature of cardiotoxicity in real-world and clinical trial settings, identify risk factors contributing to cardiovascular events, and propose guidelines for pre-therapy evaluations, post-infusion monitoring, and management strategies. By highlighting the urgent need for heightened awareness and proactive care, this review aims to enhance patient safety and optimize outcomes in the evolving landscape of CAR T-cell therapy.

摘要

嵌合抗原受体(CAR)T细胞疗法已成为一种开创性的免疫治疗方法,尤其适用于对传统治疗难治的血液肿瘤患者。随着临床试验将CAR T细胞疗法的应用扩展到血液系统恶性肿瘤之外,深入了解其相关毒性,尤其是心血管并发症,变得至关重要。本综述综合了当前关于细胞因子释放综合征(CRS)与CAR T细胞疗法相关心脏毒性之间相互作用的文献,强调了这些不良事件的潜在严重性。虽然在管理CRS方面取得了重大进展,但在关键研究中,从轻度事件到危及生命的并发症等心脏表现仍报告不足。我们探讨了真实世界和临床试验环境中心脏毒性的发生率和性质,确定了导致心血管事件的风险因素,并提出了治疗前评估、输注后监测和管理策略的指导原则。通过强调提高认识和积极护理的迫切需求,本综述旨在在不断发展的CAR T细胞疗法领域提高患者安全性并优化治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5e/12094984/ed5b2cde80dd/fphar-16-1578157-g001.jpg

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