Glycyrrhizin for treatment of CRS caused by CAR T-cell therapy: A pharmacological perspective

Abstract

Chimeric antigen receptor T (CAR T)-cell therapy promises to revolutionize the management of hematologic malignancies and possibly other tumors. However, the main side effect of cytokine release syndrome (CRS) is a great challenge for its clinical application. Currently, treatment of CRS caused by CAR T-cell therapy is limited to tocilizumab (TCZ) and corticosteroids in clinical guidelines. However, the theoretical risks of these two agents may curb clinicians’ enthusiasm for their application, and the optimal treatment is still debated. CAR T-cell therapy induced-CRS treatment is a current research focus. Glycyrrhizin, which has diverse pharmacological effects, good tolerance, and affordability, is an ideal therapeutic alternative for CRS. It can also overcome the shortcoming of TCZ and corticosteroids. In this brief article, we discuss the therapeutic potential of glycyrrhizin for treating CRS caused by CAR T-cell therapy from the perspective of its pharmacological action.

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“…All this symptomatology causes patients to develop an initial low-grade CRS that, unfortunately, may progress to a high-grade CRS with severe outcome. Currently, treatment of CRS caused by CAR T-cell therapy is limited to tocilizumab (TCZ) and corticosteroids in clinical guidelines, and also glycyrrhizin has therapeutic potential for treating CRS caused by CAR T-cell therapy ( 139 ).…”

“…Other treatments being used to alleviate these effects produced by the cytokine storm include the use of different drugs such as Glycyrrhizin ( 139 ), a pleiotropic molecule that is well tolerated and affordably priced. The interleukin-6 receptor antibody tocilizumab has been used for advanced CRS prior to the use of corticosteroids ( 140 ).…”