Is Prophylaxis the Only Way Out for Cytokine Release Syndrome Associated With Chimeric Antigen T-cell Therapy?

ABSTRACT

Chimeric antigen receptor T-cell (CAR-T) therapy is a new advancement in hematology and oncology with its use in treating many refractory malignancies. Cytokine release syndrome (CRS) is CAR-T's clinically hazardous side effect, ranging from mild to life-threatening events. It was one of the first side effects detected with CAR-T. We conducted a literature review using PubMed (MeSH) to study CRS incidence after the administration of CAR-T to reflect its clinical importance. Nine studies are mentioned, with a total of 1357 patients enrolled for different types of refractory/relapsed cancers, and an average incidence of CRS of 64% is being noted. We have also stated numerous studies which mentioned the use and effectiveness of the commonly used drugs like tocilizumab, corticosteroids, and some new drugs. Although statistical data on CRS's conservative and supportive management is not available, the role of different supportive measures is evident. An overview of how it sets the framework of a peri-management approach has been considered. Through heightened incidence and relatively complex management of CRS, we would like to raise the question of the need for early prophylaxis against CRS when considering CAR-T. The need for more clinical trials in the future to prove the effectiveness of the latter is stated.