Abstract
Chimeric antigen receptor T-cell (CAR-T) therapy is a new advancement in hematology and oncology with its use in treating many refractory malignancies. Cytokine release syndrome (CRS) is CAR-T's clinically hazardous side effect, ranging from mild to life-threatening events. It was one of the first side effects detected with CAR-T. We conducted a literature review using PubMed (MeSH) to study CRS incidence after the administration of CAR-T to reflect its clinical importance. Nine studies are mentioned, with a total of 1357 patients enrolled for different types of refractory/relapsed cancers, and an average incidence of CRS of 64% is being noted. We have also stated numerous studies which mentioned the use and effectiveness of the commonly used drugs like tocilizumab, corticosteroids, and some new drugs. Although statistical data on CRS's conservative and supportive management is not available, the role of different supportive measures is evident. An overview of how it sets the framework of a peri-management approach has been considered. Through heightened incidence and relatively complex management of CRS, we would like to raise the question of the need for early prophylaxis against CRS when considering CAR-T. The need for more clinical trials in the future to prove the effectiveness of the latter is stated.
Highlights
BackgroundChimeric Antigen Receptor (CAR) Therapy is T-cell immunotherapy used to treat lymphoid malignancies [1]
Its use began with treating pediatric acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL) [1]
We used the keywords 'chimeric antigen therapy', 'immunotherapy' or ‘axicabatagene’, and combined them using the Boolean operator 'and' with the words 'cytokine release syndrome,' 'toxicity,' 'incidence,' 'tocilizumab,' 'prophylaxis', and 'management.' We included studies comprising of clinical trials, randomized control trials, case reports, and systematic reviews performed in humans only
Summary
Chimeric Antigen Receptor (CAR) Therapy is T-cell immunotherapy used to treat lymphoid malignancies [1]. Prolific advances are being made to make it proficient in treating adult refractory Hodgkin's lymphoma, acute myeloid leukemia (AML), multiple myeloma (MM), and neuroblastoma [2] It comprises genetically engineered CAR-T cells designed to target tumor cell antigens and spare the healthy cells [3]. A unique example is interferon (IFN)-beta; it reduces the immune response and protects many inflammatory disease states, such as multiple sclerosis [8]. Another important cytokine, IL-6, acts via signal transduction and Janus kinase (JAK)/signal transducer and activator. The concluding results eventually set the base for early consideration of prophylaxis to bring down the incidence rates [12]
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