Toxicities of Chimeric Antigen Receptor T Cell Therapy in Multiple Myeloma: An Overview of Experience From Clinical Trials, Pathophysiology, and Management Strategies.
Antigens, Neoplasm
/ immunology
Brain Diseases
/ etiology
Cell Degranulation
Clinical Trials as Topic
Cytokine Release Syndrome
/ etiology
Disease Management
Endothelium, Vascular
/ metabolism
Granzymes
/ metabolism
Hospitalization
Humans
Immunotherapy, Adoptive
/ adverse effects
Lymphocyte Activation
Multiple Myeloma
/ therapy
Palliative Care
Pancytopenia
/ etiology
Perforin
/ metabolism
T-Cell Antigen Receptor Specificity
T-Lymphocyte Subsets
/ immunology
CAR T cell
clinical trial
management
multiple myeloma
pathophysiology
toxicity
Journal
Frontiers in immunology
ISSN: 1664-3224
Titre abrégé: Front Immunol
Pays: Switzerland
ID NLM: 101560960
Informations de publication
Date de publication:
2020
2020
Historique:
received:
22
10
2020
accepted:
24
11
2020
entrez:
11
1
2021
pubmed:
12
1
2021
medline:
8
7
2021
Statut:
epublish
Résumé
In the last few years, monoclonal antibodies (mAbs) such as elotuzumab and daratutumab have brought the treatment of multiple myeloma (MM) into the new era of immunotherapy. More recently, chimeric antigen receptor (CAR) modified T cell, a novel cellular immunotherapy, has been developed for treatment of relapsed/refractory (RR) MM, and early phase clinical trials have shown promising efficacy of CAR T cell therapy. Many patients with end stage RRMM regard CAR T cell therapy as their "last chance" and a "hope of cure". However, severe adverse events (AEs) and even toxic death related to CAR T cell therapy have been observed. The management of AEs related to CAR T cell therapy represents a new challenge, as the pathophysiology is not fully understood and there is still no well-established standard of management. With regard to CAR T cell associated toxicities in MM, in this review, we will provide an overview of experience from clinical trials, pathophysiology, and management strategies.
Identifiants
pubmed: 33424871
doi: 10.3389/fimmu.2020.620312
pmc: PMC7793717
doi:
Substances chimiques
Antigens, Neoplasm
0
Perforin
126465-35-8
Granzymes
EC 3.4.21.-
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
620312Informations de copyright
Copyright © 2020 Zhou, Rasche, Kortüm, Danhof, Hudecek and Einsele.
Déclaration de conflit d'intérêts
MH is listed as an inventor on patent applications and granted patents related to CAR-T technologies that have been filed by the Fred Hutchinson Cancer Research Center, Seattle, WA and by the University of Würzburg, Würzburg, Germany. MH received honoraria from Celgene/BMS, Janssen, Kite/Gilead. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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