Management of Immune-Related Adverse Events in Patients Treated With Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline
| Autor: | John A. Thompson, Jeffrey S. Weber, Leslie A. Fecher, Cristina A. Reichner, Yinghong Wang, Maria E. Suarez-Almazor, Michael B. Atkins, Carole Seigel, Milan J. Anadkat, Umang Swami, Laura Diane Porter, Sherry Adkins, Alexander I. Spira, Tanyanika Phillips, Monalisa Ghosh, Ishmael Jaiyesimi, M. S. Ernstoff, Jarushka Naidoo, Jeffrey M. Caterino, Jung-Min Song, Marianne Davies, Ian Chau, Aung Naing, Kelly J. Brassil, Loretta J. Nastoupil, Bryan J. Schneider, Jennifer S. Mammen, Christina Lacchetti, Bianca Santomasso, Pauline Funchain, Kathryn Bollin, Praveen Vikas |
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| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
Drug-Related Side Effects and Adverse Reactions business.industry Disease Management Guideline Prognosis Immunotherapy Adoptive Chimeric antigen receptor Immune system Oncology Neoplasms Immunology Practice Guidelines as Topic Medicine Humans Chimeric Antigen Receptor T-Cell Therapy In patient business Adverse effect Cytokine Release Syndrome |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 39(35) |
| ISSN: | 1527-7755 |
| Popis: | PURPOSE To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events (irAEs) in patients treated with chimeric antigen receptor (CAR) T-cell therapy. METHODS A multidisciplinary panel of medical oncology, neurology, hematology, emergency medicine, nursing, trialists, and advocacy experts was convened to develop the guideline. Guideline development involved a systematic literature review and an informal consensus process. The systematic review focused on evidence published from 2017 to 2021. RESULTS The systematic review identified 35 eligible publications. Because of the paucity of high-quality evidence, recommendations are based on expert consensus. RECOMMENDATIONS The multidisciplinary team issued recommendations to aid in the recognition, workup, evaluation, and management of the most common CAR T-cell–related toxicities, including cytokine release syndrome, immune effector cell–associated neurotoxicity syndrome, B-cell aplasia, cytopenias, and infections. Management of short-term toxicities associated with CAR T cells begins with supportive care for most patients, but may require pharmacologic interventions for those without adequate response. Management of patients with prolonged or severe CAR T-cell–associated cytokine release syndrome includes treatment with tocilizumab with or without a corticosteroid. On the basis of the potential for rapid decline, patients with moderate to severe immune effector cell–associated neurotoxicity syndrome should be managed with corticosteroids and supportive care. Additional information is available at www.asco.org/supportive-care-guidelines . |
| Databáze: | OpenAIRE |
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