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Reactions and adverse events induced by T-cell engagers as anti-cancer immunotherapies, a comprehensive review
Ist Teil von
European journal of cancer (1990), 2024-07, Vol.205, p.114075, Article 114075
Ort / Verlag
England: Elsevier Ltd
Erscheinungsjahr
2024
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
T-cell engagers (TCE) are cancer immunotherapies that have recently demonstrated meaningful benefit for patients with hematological malignancies and solid tumors. The anticipated widespread use of T cell engagers poses implementation challenges and highlights the need for guidance to anticipate, mitigate, and manage adverse events. By mobilizing T-cells directly at the contact of tumor cells, TCE mount an obligatory and immediate anti-tumor immune response that could result in diverse reactions and adverse events. Cytokine release syndrome (CRS) is the most common reaction and is largely confined to the first drug administrations during step-up dosage. Cytokine release syndrome should be distinguished from infusion related reaction by clinical symptoms, timing to occurrence, pathophysiological aspects, and clinical management. Other common reactions and adverse events with TCE are immune effector Cell-Associated Neurotoxicity Syndrome (ICANS), infections, tumor flare reaction and cytopenias. The toxicity profiles of TCE and CAR-T cells have commonalities and distinctions that we sum-up in this review. As compared with CAR-T cells, TCE are responsible for less frequently severe CRS or ICANS. This review recapitulates terminology, pathophysiology, severity grading system and management of reactions and adverse events related to TCE.
•Infusion related reactions and cytokine release syndromes (CRS) should be distinguished.•Cytokine release syndrome is the most common reaction with T-cell engagers (TCE).•Cytokine release syndromes is confined to first step-up dosages of T-cell engagers.•Most common toxicities with TCE are CRS, ICANS, infections, tumor flare reactions.•As compared with CAR-T cells, TCE generate less frequently severe CRS or ICANS.