[Immuno-Oncology Meets Intensive Care Medicine: CAR-T cells]

Dtsch Med Wochenschr. 2019 Sep;144(19):1342-1347. doi: 10.1055/a-0853-4689. Epub 2019 Sep 26.
[Article in German]

Abstract

CAR-T cells, genetically modified tumor-targeted t-cells, revolutionized the treatment of refractory B-cell malignancies. CAR-T cell treatment however, is invariably associated with severe immune-mediated toxicities, namely Cytokine Release Syndrome (CRS) and neurological toxicity (CRES/ICANS). Although knowledge on the pathomechanism of these toxicities is still very limited, recent findings including mouse models might allow prediction, earlier recognition and targeted treatment of patients suffering from these potentially life-threatening side effects. This article summarizes current knowledge and recent findings on the management of severe CAR-T associated toxicities and gaps of knowledge stressing the importance of an interdisciplinary approach including hematology-oncology and Intensive Care Medicine.

Publication types

  • Review

MeSH terms

  • Animals
  • Critical Care / methods*
  • Cytokine Release Syndrome* / etiology
  • Cytokine Release Syndrome* / therapy
  • Disease Models, Animal
  • Humans
  • Immunotherapy, Adoptive / adverse effects*
  • Mice
  • Neoplasms / therapy*