Safety evaluation of axicabtagene ciloleucel for relapsed or refractory large B-cell lymphoma Review
| Authors: | Nath, K.; Wudhikarn, K.; Alarcon Tomas, A.; Perales, M. A. |
| Review Title: | Safety evaluation of axicabtagene ciloleucel for relapsed or refractory large B-cell lymphoma |
| Abstract: | Introduction: CD19-directed chimeric antigen receptor (CAR) T-cell therapy is a highly effective therapy for patients with relapsed/refractory large B-cell lymphoma (LBCL) and three CD19 CAR T-cell products (axicabtagene ciloleucel, tisagenlecleucel and lisocabtagene maraleucel) are currently approved for this indication. Despite the clinical benefit of CD19 directed CAR T-cell therapy, this treatment is associated with significant morbidity from treatment-emergent toxicities. Areas covered: This Review discusses the safety considerations of axicabtagene ciloleucel in patients with LBCL. This includes discussion of the frequently observed immune-mediated toxicities of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. Additionally, we review CAR T-cell therapy related cytopenias, infection, organ dysfunction and the more recently described hemophagocytic lymphohistiocytosis. Expert Opinion: A thorough understanding of the toxicities associated with CD19-directed CAR T-cell therapy will facilitate the optimal selection of patients for this therapy. Furthermore, knowledge of preventative measures of CAR T-cell related complications, and early recognition and appropriate intervention will lead to the safe administration of these therapies, and ultimately improved outcomes for our patients. © 2023 Informa UK Limited, trading as Taylor & Francis Group. |
| Keywords: | treatment outcome; pathology; lymphoma, large b-cell, diffuse; adoptive immunotherapy; immunotherapy, adoptive; cd19 antigen; antigens, cd19; adverse event; diffuse large b cell lymphoma; humans; human; axicabtagene ciloleucel; chimeric antigen receptor (car) t-cell therapy; receptors, chimeric antigen; cytokine release syndrome (crs); cell-associated neurotoxicity; immune effector cell-associated neurotoxicity syndrome (icans); large b-cell lymphoma (lbcl) |
| Journal Title: | Expert Opinion on Drug Safety |
| Volume: | 22 |
| Issue: | 1 |
| ISSN: | 1474-0338 |
| Publisher: | Informa Healthcare |
| Date Published: | 2023-01-01 |
| Start Page: | 5 |
| End Page: | 15 |
| Language: | English |
| DOI: | 10.1080/14740338.2023.2177268 |
| PUBMED: | 36737060 |
| PROVIDER: | scopus |
| PMCID: | PMC9975047 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Miguel-Angel Perales -- Source: Scopus |
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