Chimeric antigen receptor T-cell therapy for cancer and heart Review
| Authors: | Ganatra, S.; Carver, J. R.; Hayek, S. S.; Ky, B.; Leja, M. J.; Lenihan, D. J.; Lenneman, C.; Mousavi, N.; Park, J. H.; Perales, M. A.; Ryan, T. D.; Scherrer-Crosbie, M.; Steingart, R. M.; Yang, E. H.; Zaha, V.; Barac, A.; Liu, J. E. |
| Review Title: | Chimeric antigen receptor T-cell therapy for cancer and heart |
| Abstract: | Chimeric antigen receptor (CAR) T-cell therapy has significantly advanced the treatment of patients with relapsed and refractory hematologic malignancies and is increasingly investigated as a therapeutic option of other malignancies. The main adverse effect of CAR T-cell therapy is potentially life-threatening cytokine release syndrome (CRS). Clinical cardiovascular (CV) manifestations of CRS include tachycardia, hypotension, troponin elevation, reduced left ventricular ejection fraction, pulmonary edema, and cardiogenic shock. Although insults related to CRS toxicity might be transient and reversible in most instances in patients with adequate CV reserve, they can be particularly challenging in higher-risk, often elderly patients with pre-existing CV disease. As the use of CAR T-cell therapy expands to include a wider patient population, careful patient selection, pre-treatment cardiac evaluation, and CV risk stratification should be considered within the CAR T-cell treatment protocol. Early diagnosis and management of CV complications in patients with CRS require awareness and multidisciplinary collaboration. © 2019 American College of Cardiology Foundation |
| Keywords: | review; cancer recurrence; patient selection; t lymphocyte; cancer immunotherapy; heart disease; clinical protocol; patient monitoring; kidney carcinoma; monoclonal antibody; hypotension; hematologic malignancy; adverse outcome; early diagnosis; cardiovascular disease; cardiovascular risk; cardiotoxicity; medical specialist; chimeric antigen receptor; cell therapy; tumor immunity; clinical effectiveness; heart left ventricle ejection fraction; tachycardia; professional knowledge; early intervention; lung edema; cytokine release syndrome; troponin; cardiogenic shock; human; priority journal; multidisciplinary team; malignant neoplasm; chimeric antigen receptor t-cell therapy |
| Journal Title: | Journal of the American College of Cardiology |
| Volume: | 74 |
| Issue: | 25 |
| ISSN: | 0735-1097 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2019-01-01 |
| Start Page: | 3153 |
| End Page: | 3163 |
| Language: | English |
| DOI: | 10.1016/j.jacc.2019.10.049 |
| PROVIDER: | scopus |
| PUBMED: | 31856973 |
| DOI/URL: | |
| Notes: | Review -- Source: Scopus |
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