Long‐term survivorship care after CAR‐T cell therapy

Abstract

While cytokine release syndrome and immune effector cell‐associated neurotoxicity syndrome are well‐recognized acute toxicities of chimeric antigen receptor (CAR) T cell therapy, these complications have become increasingly manageable by protocolized treatment algorithms incorporating the early administration of tocilizumab and corticosteroids. As CAR‐T cell therapy expands to new disease indications and the number of long‐term survivors steadily increases, there is growing recognition of the need to appropriately evaluate and manage the late effects of CAR‐T cell therapy, including late‐onset or persistent neurotoxicity, prolonged cytopenias, delayed immune reconstitution and infections, subsequent malignancies, organ dysfunction, psychological distress, and fertility implications. In this review, we provide a practical approach to the long‐term survivorship care of the CAR‐T cell recipient, with a focus on the optimal strategies to address the common and challenging late complications affecting this unique population.

Sculpting nursing resilience: Transforming lives, nurturing ethics in chimeric antigen receptor T‐cell therapy

“…However, challenges remain challenging the need to be overcome to make this therapy more effective, safe, and accessible for a wider range of cancers. Recent advancement includes a computational approach where tumour cells are targeted with peptide‐centric CAR T‐cell (a new class of engineered T cells that can recognize and eradicate), 5 synthetic gene circuits, 6 traffickings and infiltration of CAR T‐cells into solid tumours by engineering them with chemokine receptors, integrins, or enzymes that can degrade the extracellular matrix 6 and for such complex treatment regimens a nurse who is well trained, knowledgeable and skilful has a crucial integral role in providing comprehensive nursing health service to patients 7–10 …”

Chimeric antigen receptor T‐cell therapy, where are we now and where are we heading for

“…We are excited to see the number of long‐term survivors after CAR‐T‐cell therapy steadily increases, but there is growing need to appropriately evaluate and manage the late effects of this novel therapy, such as prolonged cytopenia, delayed immune reconstitution, infections, secondary malignancies, and fertility implications, and so on. A practical approach to the long‐term survivorship care of the CAR‐T‐cell recipient was proposed to address the common and challenging late complications 5 …”