Immune effector cells toxicity management

Page co-editor		Page co-editor
	Leyre Zubiri, MD, PhD Massachusetts General Hospital Boston, MA		Matthew Hadfield, DO Lifespan/Brown University Providence, RI LinkedIn

The purpose of this page is to address the management of toxicity from BiTE and immune effector cell (IEC) therapy, notably CAR-T. There is a separate page for the management of immune checkpoint inhibitor (ICI) toxicities, available here.

Guidelines

ASCO

• 2021: Santomasso et al. Management of Immune-Related Adverse Events in Patients Treated With Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline

ASTCT

• 2019: Lee et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells

EBMT/JACIE/EHA

• 2022: Hayden et al. Management of adults and children receiving CAR T-cell therapy: 2021 best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association (EHA) PubMed

SITC

• 2020: Maus et al. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune effector cell-related adverse events

REMS programs for CAR T-cells

• Axicabtagene ciloleucel (Yescarta)
• Brexucabtagene autoleucel (Tecartus)
• Ciltacabtagene autoleucel (Carvykti)
• Idecabtagene vicleucel (Abecma)
• Lisocabtagene maraleucel (Breyanzi)
• Tisagenlecleucel (Kymriah)