Dr. Hill on Managing CRS in Patients Treated With CAR T-Cell Therapy

Brian T. Hill, MD, PhD, director of the Lymphoid Malignancies Program and staff physician, Taussig Cancer Institute, and assistant professor, Hematology and Oncology, Cleveland Clinic, discusses the management of cytokine release syndrome (CRS) in patients with hematologic malignancies who are treated with CAR T-cell therapy.

CRS, or cytokine storm, is caused by a high activation level of immune effector cells that are mediated by cytokines, such as interleukin-6 (IL-6), Hill says. Typically, CRS occurs within the first 2 to 4 days following administration of CAR T-cell therapy.

The cytokines induce a sepsis-like physiological response that may include fever, tachycardia, hypoxia, or hypotension, says Hill. Moreover, these adverse effects typically require the patient to be treated in the intensive care unit.

Management strategies for CRS include the administration of tocilizumab (Actemra), which is an anti­­–IL-6 monoclonal antibody, Hill explains.

However, treatment should take place at an expert-level facility that is experienced in managing CRS, concludes Hill.