Cytokine release syndrome and neurologic toxicities associated with chimeric antigen receptor T-cell therapy: A comprehensive review of emerging grading models

• Main Authors: Julio C. Chavez, Michael D. Jain, Mohamed A. Kharfan-Dabaja
• Format: Article
• Language: English
• Published: Elsevier 2020-03-01
• Series: Hematology/Oncology and Stem Cell Therapy
• Online Access: http://www.sciencedirect.com/science/article/pii/S1658387619300500

Advances in the fields of immuno-oncology and T-cell engineering have brought autologous chimeric antigen receptor T-cell (CART) therapies from the bench to the bedside. At present, two CART products that target CD19 are commercially available: tisagenlecleucel and axicabtagene ciloleucel. They have demonstrated remarkable efficacy for their particular indications. One challenge is to compare the safety among commercially available and clinical trial CART treatments due to the use of different grading models to assess the severity of cytokine release syndrome and neurotoxicity. An unmet need exists to harmonize current grading models in order to develop uniform treatment strategies to manage these toxicities. Here, we attempt to summarize the evolution of the various grading systems for cytokine release syndrome and neurotoxicity and also highlight the major differences among them, whenever applicable. Keywords: Chimeric antigen receptor T-cell therapy, Cytokine release syndrome, Neurotoxicity