In the Eye of the Storm: Immune-Mediated Toxicities Associated With CAR-T Cell Therapy

The success of chimeric antigen receptor (CAR) T-cell therapy in hematologic malignancies also carries with it the potential for unexpected, potentially life-threatening immune-mediated toxicities, namely cytokine release syndrome (CRS) and neurotoxicity, also referred to as “immune effector cell-associated neurotoxicity syndrome” (ICANS). These toxicities require urgent diagnostic and therapeutic interventions and targeted modulation of key cytokine pathways. In this article, the authors present the current evidence of CRS and ICANS pathophysiology, diagnostics, and treatment.