Toxicities, intensive care management, and outcome of chimeric antigen receptor T cells in adults: an update

Bellal, Mathieu; Malherbe, Jolan; Damaj, Gandhi; Du Cheyron, Damien

doi:10.1186/s13054-024-04851-0

Crit Care

2024

DOI: 10.1186/s13054-024-04851-0

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Toxicities, intensive care management, and outcome of chimeric antigen receptor T cells in adults: an update

Mathieu Bellal,

Jolan Malherbe,

Gandhi Damaj

et al.

Abstract: Background Chimeric antigen receptor T cells are a promising new immunotherapy for haematological malignancies. Six CAR-T cells products are currently available for adult patients with refractory or relapsed high-grade B cell malignancies, but they are associated with severe life-threatening toxicities and side effects that may require admission to ICU. Objective The aim of this short pragmatic review is to synthesize for intensivists the knowledge… Show more

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2024

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Cited by 7 publications

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Chimeric antigen receptor T-cell therapy for autoimmune diseases of the central nervous system: a systematic literature review

Konitsioti,

Prüss,

Laurent

et al. 2024

J Neurol

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Importance B-cell-targeting monoclonal antibodies have demonstrated safety and efficacy in multiple sclerosis or anti-aquaporin-4 IgG positive neuromyelitis optica spectrum disorder. However, these therapies do not facilitate drug-free remission, which may become possible with cell-based therapies, including chimeric antigen receptor (CAR) T cells. CAR T-cell therapy holds promise for addressing other antibody-mediated CNS disorders, e.g., MOG-associated disease or autoimmune encephalitis. Objective To provide an overview of the current clinical knowledge on CAR T-cell therapy in central nervous system autoimmunity. Evidence review We searched PubMed, Embase, Google Scholar, PsycINFO, and clinicaltrials.gov using the terms ‘CAR T cell’ and ‘multiple sclerosis/MS’ or ‘neuromyelitis optica/spectrum diseases/NMOSD’ or ‘MOG-associated disease/MOGAD ‘or’ autoimmune encephalitis’ or ‘neuroimmunology’. Findings An ongoing phase I clinical trial has indicated the safety and benefits of anti-BCMA CAR T cells in 12 patients with AQP4-IgG seropositive neuromyelitis optica spectrum disorder. Case reports involving two individuals with progressive multiple sclerosis and one patient with stiff-person syndrome demonstrated a manageable safety profile following treatment with anti-CD19 CAR T cells. Recruitment has commenced for two larger studies in MS, and a phase I open-label basket study is underway to evaluate BCMA-directed CAR T cells in various antibody-associated inflammatory diseases, including MOG-associated disease. Preclinical research on NMDA receptor antibody autoimmune encephalitis treated with chimeric autoantibody receptor T cells generated promising data. Conclusions and relevance There is minimal evidence of the benefits of CAR T-cell therapy in individuals with central nervous system-directed autoimmunity. Nevertheless, multicenter controlled clinical trials with a manageable safety profile appear feasible and are warranted due to very promising case experiences.

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Chimeric antigen receptor T-cell therapy for autoimmune diseases of the central nervous system: a systematic literature review

Konitsioti,

Prüss,

Laurent

et al. 2024

J Neurol

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Molecular profiling and therapeutic tailoring to address disease heterogeneity in systemic lupus erythematosus

Karmakar,

Kumar,

Prabhu

et al. 2024

Clin Exp Med

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Systemic lupus erythematosus (SLE) is a chronic, heterogeneous, systemic autoimmune disease characterized by autoantibody production, complement activation, and immune complex deposition. SLE predominantly affects young, middle-aged, and child-bearing women with episodes of flare-up and remission, although it affects males at a much lower frequency (female: male; 7:1 to 15:1). Technological and molecular advancements have helped in patient stratification and improved patient prognosis, morbidity, and treatment regimens overall, impacting quality of life. Despite several attempts to comprehend the pathogenesis of SLE, knowledge about the precise molecular mechanisms underlying this disease is still lacking. The current treatment options for SLE are pragmatic and aim to develop composite biomarkers for daily practice, which necessitates the robust development of novel treatment strategies and drugs targeting specific responsive pathways. In this communication, we review and aim to explore emerging therapeutic modalities, including multiomics-based approaches, rational drug design, and CAR-T-cell-based immunotherapy, for the management of SLE.

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Smart Cell Therapy: an industry perspective on macrophages as living drugs

Rodgers,

Novobrantseva,

Barcia

2024

Cytotherapy

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scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

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Toxicities, intensive care management, and outcome of chimeric antigen receptor T cells in adults: an update

Cited by 7 publications

References 83 publications

Chimeric antigen receptor T-cell therapy for autoimmune diseases of the central nervous system: a systematic literature review

Chimeric antigen receptor T-cell therapy for autoimmune diseases of the central nervous system: a systematic literature review

Molecular profiling and therapeutic tailoring to address disease heterogeneity in systemic lupus erythematosus

Smart Cell Therapy: an industry perspective on macrophages as living drugs

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