Dr. Deol on the Safety of CAR T-Cell Therapy

Abhinav Deol, MD, associate professor with Karmanos Cancer Institute, discusses patient eligibility for chimeric antigen receptor (CAR) T-cell therapy in hematologic oncology.

Once a clinician determines a patient’s eligibility to receive CAR T-cell therapy, physicians watch for cytokine release syndrome (CRS) and neurological toxicities. In some mild cases, the CRS can be characterized by fevers, chills, and slightly low blood pressure that responds to intravenous fluids, explains Deol. However, extreme cases may manifest in high fevers and blood pressure that drops low enough to require medication.

In terms of neurological toxicity, some patients do not experience any. Other patients may have mild confusion. In severe cases, patients can become comatose or have seizures as a result of neurotoxicity. To date, the companies that produce the CAR T products have been very careful to only have sites that have experience and sufficient training treat patients, says Deol. They are limiting the first roll-out to sites that are able to manage these toxicities, because it is a multimodality management, adds Deol.