Dr. Andreadis Discusses Toxicities With CAR T-Cell Therapy

Charalambos (Babis) Andreadis, MD, MSCE, associate professor of clinical medicine, Department of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, discusses toxicities associated with chimeric antigen receptor (CAR) T-cell therapy.

The main toxicities associated with CAR T-cell therapy exist in 2 broad spheres, says Andreadis. One is cytokine release syndrome (CRS), which presents with fever, low blood pressure, low oxygen level, and organ toxicity. These toxicities usually occur within the first week after therapy. The second sphere is short-term toxicities, which can be confusion, inability to speak, disorientation, tremors, and possibly coma. These also usually occur within the first week, but often last a little longer than the toxicities associated with CRS, says Andreadis.

Physicians need to be educated and trained in order to safely administer CAR T-cell therapy and manage the toxicities, Andreadis adds. Once the acute phase is over, most patients can return to their local physicians. Andreadis explains that the long-term side effects such as low blood counts are manageable, and physicians and patients should be hypervigilant about infections.