What are the strategies to manage toxicities with CAR T-cell therapies?

During the 6th European CAR T-Cell Meeting, the Lymphoma Hub was pleased to speak to the president of EBMT, Anna Sureda, Catalan Institute of Oncology, Barcelona, ES. We asked, What are the strategies to manage toxicities with CAR T-cell therapies?

Firstly, Sureda highlights that while CAR T-cell therapies have made significant improvements in the treatment of hematologic malignancies, they are associated with early and long-term toxicities that need to be managed. The two most important early toxicities are cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. The management approach includes the earlier use of tocilizumab for cytokine release syndrome and pre-emptive corticosteroids for immune effector cell-associated neurotoxicity syndrome, taking certain risk factors into account, such as tumor burden, age, and performance status.  

Sureda then mentions other clinical toxicities associated with CAR T-cell therapies, such as hematologic toxicities, cytopenias, and the ongoing measures to manage these. She concludes by discussing the recent development of secondary malignancies post CAR T-cell therapy including myelodysplastic syndromes and acute myeloid leukemia; investigations are ongoing to further understand the profile of this toxicity.