Cytokine release syndrome and associated neurotoxicity in cancer immunotherapy.
Emma Catherine MorrisSattva S NeelapuTheodoros GiavridisMichel SadelainPublished in: Nature reviews. Immunology (2021)
A paradigm shift has recently occurred in the field of cancer therapeutics. Traditional anticancer agents, such as chemotherapy, radiotherapy and small-molecule drugs targeting specific signalling pathways, have been joined by cellular immunotherapies based on T cell engineering. The rapid adoption of novel, patient-specific cellular therapies builds on scientific developments in tumour immunology, genetic engineering and cell manufacturing, best illustrated by the curative potential of chimeric antigen receptor (CAR) T cell therapy targeting CD19-expressing malignancies. However, the clinical benefit observed in many patients may come at a cost. In up to one-third of patients, significant toxicities occur that are directly associated with the induction of powerful immune effector responses. The most frequently observed immune-mediated toxicities are cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. This Review discusses our current understanding of their pathophysiology and clinical features, as well as the development of novel therapeutics for their prevention and/or management.
Keyphrases
- cell therapy
- small molecule
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- prognostic factors
- early stage
- single cell
- stem cells
- dendritic cells
- peritoneal dialysis
- locally advanced
- cancer therapy
- gene expression
- squamous cell carcinoma
- drug delivery
- young adults
- quantum dots
- protein protein
- dna methylation