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Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies
Chimeric antigen receptor (CAR)-T cell therapy is the next revolutionary advance in cancer therapy. By using ex vivo engineered T cells to specifically target antigens, a targeted immune reaction is induced. Chimeric antigen receptor-T cell therapy is approved for patients suffering from advanced an...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123242/ https://www.ncbi.nlm.nih.gov/pubmed/35257157 http://dx.doi.org/10.1093/eurheartj/ehac106 |
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author | Totzeck, Matthias Michel, Lars Lin, Yi Herrmann, Joerg Rassaf, Tienush |
author_facet | Totzeck, Matthias Michel, Lars Lin, Yi Herrmann, Joerg Rassaf, Tienush |
author_sort | Totzeck, Matthias |
collection | PubMed |
description | Chimeric antigen receptor (CAR)-T cell therapy is the next revolutionary advance in cancer therapy. By using ex vivo engineered T cells to specifically target antigens, a targeted immune reaction is induced. Chimeric antigen receptor-T cell therapy is approved for patients suffering from advanced and refractory B cell and plasma cell malignancies and is undergoing testing for various other haematologic and solid malignancies. In the process of triggering an anticancer immune reaction, a systemic inflammatory response can emerge as cytokine release syndrome (CRS). The severity of CRS is highly variable across patients, ranging from mild flu-like symptoms to fulminant hyperinflammatory states with excessive immune activation, associated multiorgan failure and high mortality risk. Cytokine release syndrome is also an important factor for adverse cardiovascular (CV) events. Sinus tachycardia and hypotension are the most common reflections, similar to what is seen with other systemic inflammatory response syndromes. Corrected QT interval prolongation and tachyarrhythmias, including ventricular arrhythmias and atrial fibrillation, also show a close link with CRS. Events of myocardial ischaemia and venous thromboembolism can be provoked during CAR-T cell therapy. Although not as closely related to CRS, changes in cardiac function can be observed to the point of heart failure and cardiogenic shock. This may also be encountered in patients with severe valvular heart disease in the setting of CRS. This review will discuss the pertinent CV risks of the growing field of CAR-T cell therapy for today’s cardiologists, including incidence, characteristics, and treatment options, and will conclude with an integrated management algorithm. |
format | Online Article Text |
id | pubmed-9123242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-91232422022-05-23 Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies Totzeck, Matthias Michel, Lars Lin, Yi Herrmann, Joerg Rassaf, Tienush Eur Heart J State of the Art Review Chimeric antigen receptor (CAR)-T cell therapy is the next revolutionary advance in cancer therapy. By using ex vivo engineered T cells to specifically target antigens, a targeted immune reaction is induced. Chimeric antigen receptor-T cell therapy is approved for patients suffering from advanced and refractory B cell and plasma cell malignancies and is undergoing testing for various other haematologic and solid malignancies. In the process of triggering an anticancer immune reaction, a systemic inflammatory response can emerge as cytokine release syndrome (CRS). The severity of CRS is highly variable across patients, ranging from mild flu-like symptoms to fulminant hyperinflammatory states with excessive immune activation, associated multiorgan failure and high mortality risk. Cytokine release syndrome is also an important factor for adverse cardiovascular (CV) events. Sinus tachycardia and hypotension are the most common reflections, similar to what is seen with other systemic inflammatory response syndromes. Corrected QT interval prolongation and tachyarrhythmias, including ventricular arrhythmias and atrial fibrillation, also show a close link with CRS. Events of myocardial ischaemia and venous thromboembolism can be provoked during CAR-T cell therapy. Although not as closely related to CRS, changes in cardiac function can be observed to the point of heart failure and cardiogenic shock. This may also be encountered in patients with severe valvular heart disease in the setting of CRS. This review will discuss the pertinent CV risks of the growing field of CAR-T cell therapy for today’s cardiologists, including incidence, characteristics, and treatment options, and will conclude with an integrated management algorithm. Oxford University Press 2022-03-08 /pmc/articles/PMC9123242/ /pubmed/35257157 http://dx.doi.org/10.1093/eurheartj/ehac106 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | State of the Art Review Totzeck, Matthias Michel, Lars Lin, Yi Herrmann, Joerg Rassaf, Tienush Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies |
title | Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies |
title_full | Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies |
title_fullStr | Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies |
title_full_unstemmed | Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies |
title_short | Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies |
title_sort | cardiotoxicity from chimeric antigen receptor-t cell therapy for advanced malignancies |
topic | State of the Art Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123242/ https://www.ncbi.nlm.nih.gov/pubmed/35257157 http://dx.doi.org/10.1093/eurheartj/ehac106 |
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