Oncology Brothers: Practice-Changing Cancer Discussions CAR-T Toxicity Check: From Approval to Practice, Managing Side Effects of CAR-T Therapy
Dec 21, 2024
Dr. Jason Westin, a lymphoma expert at MD Anderson, and Dr. Surbhi Sidana, who leads Stanford's Myeloma CAR-T program, dive into the intricacies of CAR-T cell therapy. They discuss its powerful mechanism and its application in treating cancers. The conversation highlights acute side effects like cytokine release syndrome and neurotoxicity, alongside strategies for their management. Chronic side effects, including infection risks and monitoring practices, are also explored, providing vital insights for oncologists on patient care.
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CAR T Cell Mechanism Explained
- CAR T cells are patient lymphocytes engineered to target cancer-specific proteins like CD19 or BCMA.
- These cells expand inside the patient and act as a living therapy for weeks to months, killing targeted cancer cells.
CAR T Cells as Elite Immune Soldiers
- CAR T cells act like elite immune soldiers trained to recognize cancer cells disguised as normal cells.
- Their expansion triggers a strong immune response causing side effects similar to infection symptoms due to cytokine release.
Managing Acute CAR T Toxicities
- Monitor for cytokine release syndrome (CRS) within first two weeks, presenting with fever and low blood pressure.
- Watch for neurotoxicity (ICANS) causing confusion or obtundation, which usually appear shortly after CRS during hospital stay.