Chimeric Antigen Receptor T-Cell Therapy for Cancer and Heart: JACC Council Perspectives.


Journal

Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365

Informations de publication

Date de publication:
24 12 2019
Historique:
received: 09 06 2019
revised: 09 10 2019
accepted: 31 10 2019
entrez: 21 12 2019
pubmed: 21 12 2019
medline: 23 5 2020
Statut: ppublish

Résumé

Chimeric antigen receptor (CAR) T-cell therapy has significantly advanced the treatment of patients with relapsed and refractory hematologic malignancies and is increasingly investigated as a therapeutic option of other malignancies. The main adverse effect of CAR T-cell therapy is potentially life-threatening cytokine release syndrome (CRS). Clinical cardiovascular (CV) manifestations of CRS include tachycardia, hypotension, troponin elevation, reduced left ventricular ejection fraction, pulmonary edema, and cardiogenic shock. Although insults related to CRS toxicity might be transient and reversible in most instances in patients with adequate CV reserve, they can be particularly challenging in higher-risk, often elderly patients with pre-existing CV disease. As the use of CAR T-cell therapy expands to include a wider patient population, careful patient selection, pre-treatment cardiac evaluation, and CV risk stratification should be considered within the CAR T-cell treatment protocol. Early diagnosis and management of CV complications in patients with CRS require awareness and multidisciplinary collaboration.

Identifiants

pubmed: 31856973
pii: S0735-1097(19)38386-X
doi: 10.1016/j.jacc.2019.10.049
pmc: PMC8211027
mid: NIHMS1706147
pii:
doi:

Substances chimiques

Receptors, Chimeric Antigen 0

Types de publication

Case Reports Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

3153-3163

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States

Informations de copyright

Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Auteurs

Sarju Ganatra (S)

Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts; Cardio-Oncology and Adult Cancer Survivorship Program, Dana Farber Cancer Institute, Boston, Massachusetts; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Joseph R Carver (JR)

Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.

Salim S Hayek (SS)

Division of Cardiology, University of Michigan, Ann Arbor, Michigan.

Bonnie Ky (B)

Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.

Monika J Leja (MJ)

Division of Cardiology, University of Michigan, Ann Arbor, Michigan.

Daniel J Lenihan (DJ)

Cardio-Oncology Center of Excellence, Division of Cardiovascular Medicine, Department of Medicine, Washington University, St. Louis, Missouri.

Carrie Lenneman (C)

Division of Cardiovascular Medicine, Department of Medicine, University of Alabama, Birmingham, Alabama.

Negaresh Mousavi (N)

Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.

Jae H Park (JH)

Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.

Miguel Angel Perales (MA)

Department of Medicine, Weill Cornell Medical College, New York, New York; Adult Bone Marrow Transplant, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Thomas D Ryan (TD)

Heart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati College of Medicine, Cincinnati, Ohio.

Marielle Scherrer-Crosbie (M)

Cardio-Oncology Program and Cardiac Ultrasound Laboratory, Division of Cardiology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

Richard M Steingart (RM)

Department of Medicine, Weill Cornell Medical College, New York, New York; Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Eric H Yang (EH)

Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Ronald Reagan University of California Los Angeles Medical Center, Los Angeles, California.

Vlad Zaha (V)

Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Divison of Cardiovascular Medicine, Department of Medicine, Dallas, Texas.

Ana Barac (A)

Cardio-Oncology Program, Department of Cardiology, MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC. Electronic address: Ana.Barac@medstar.net.

Jennifer E Liu (JE)

Department of Medicine, Weill Cornell Medical College, New York, New York; Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: liuj1234@mskcc.org.

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