Immune effector cell associated neurotoxicity syndrome in chimeric antigen receptor-T cell therapy

Abstract

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Chimeric antigen receptor (CAR)-T cell therapy is an emerging staple in the treatment of certain hematological malignancies. While CAR-T cells have produced robust responses in certain hematological malignancies, toxicities associated with the therapy have limited their use. Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS) is a potentially life-threatening neurotoxicity that commonly occurs with CAR-T cell therapy. Here we will discuss ICANS, its treatment, possible mechanisms, and potential solutions to this critical limitation of CAR-T cell therapy. As the field of CAR-T cell therapy evolves, improved treatments and methods to circumvent or overcome ICANS are necessary to improve morbidity, mortality, and decrease the cost of CAR-T cell therapy. This serious, life-threatening side effect needs to be studied to better understand its mechanisms and develop treatments and alternative strategies.

Keywords

• chimeric antigen receptor-T cell (CAR-T cell) therapy
• ICANS
• immune effector cell associated neurotoxicity syndrome (ICANS)
• CAR-T cell
• neurotoxicity
• cytokine release syndrome (CRS)