Dr. Sehgal on Managing CRS and Neurotoxicity From CAR T-Cell Therapy

Video

Alison R. Sehgal, MD, assistant professor of medicine, hematologist/medical oncologist, University of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, discusses ways to manage cytokine release syndrome (CRS) and neurotoxicity associated with CAR T-cell therapy.

Alison R. Sehgal, MD, assistant professor of medicine, hematologist/medical oncologist, University of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, discusses ways to manage cytokine release syndrome (CRS) and neurotoxicity associated with CAR T-cell therapy.

The management strategies for CRS and neurotoxicity depend on the severity of the syndromes, says Sehgal. With regard to CRS experienced with axicabtagene-ciloleucel (axi-cel; Yescarta), most patients get a fever, which is classified as grade 1. These patients can be managed supportively most of the time—often with Tylenol, fluids, or other antipyretics. If the fever continues, or if it escalates to hypotension or organ dysfunction—particularly pulmonary dysfunction—then an interleukin-6 receptor blocker is often used.

If a patient develops CRS that is refractory to supportive care and tocilizumab (Actemra), many centers, in accordance with real-world data, rely on steroids to combat the toxicity. Tocilizumab does not have a role in the management of neurologic toxicity unless there is concurrent CRS. Therefore, patients who develop more severe neurologic toxicity should be moved swiftly to steroids, concludes Sehgal.

Newsletter

Stay at the forefront of cutting-edge science with CGT—your direct line to expert insights, breakthrough data, and real-time coverage of the latest advancements in cell and gene therapy.

Recent Videos
Derek Jackson, BS, MA, the vice president of cell & gene therapy product development at Pacira, and Kilian Guse, PhD, the vice president of genetic medicine platforms at Pacira
Derek Jackson, BS, MA, the vice president of cell & gene therapy product development at Pacira
Jeffrey Chamberlain, PhD
Tami John, MD
Tami John, MD
Tami John, MD
Matthew Ku, MBBS, FRACP, RACP, FRCPA/RCPA, PhD, an associate professor and the lymphoma stream lead at St Vincent’s Hospital
Saurabh Dahiya, MD, FACP, an associate professor of medicine at Stanford University School of Medicine; as well as clinical director of Cancer Cell Therapy in the Division of Blood and Marrow Transplantation and Cell Therapy at Stanford Medicine
Shahzad Raza, MD, a hematologist/oncologist at the Cleveland Clinic
Manali Kamdar, MD, the associate professor of medicine–hematology and clinical director of lymphoma services at the University of Colorado
Related Content
© 2025 MJH Life Sciences

All rights reserved.