Scholarlink

<p>CAR-T&#xa0;cell therapies are an established immunotherapy for treating refractory or relapsed B‑cell and plasma cell neoplasms. Since 2017, CD19 and BCMA have been utilized as target structures. The manufacturing process involves extracting T&#xa0;cells from patients, genetically modifying them to express a&#xa0;chimeric antigen receptor (CAR) and expanding them ex vivo. Depending on the product used, a&#xa0;necessary lymphodepleting chemotherapy is administered before infusing the modified CAR-T&#xa0;cells to specifically recognize and destroy tumor cells. The fourth generation CARs enhances the immune response through cytokine release and interaction with the tumor microenvironment. Advances such as dual- or multi-CARs enable the simultaneous recognition of multiple antigens, overcoming resistance. However, despite promising success, side effects like cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) occur. CRS typically begins within a&#xa0;few days after infusion as an acute or subacute condition with fever and other symptoms, and in severe cases, can cause organ dysfunction. ICANS manifests as encephalopathy with neurological symptoms and can occur with or without preceding CRS. The pathogenesis of CRS and ICANS involves several phases: from tumor cell recognition, through cytokine release and systemic inflammatory reaction, to the migration of CAR-T&#xa0;cells into the central nervous system and, ultimately, the resolution of inflammation. Algorithms for the diagnosis and therapy of CRS and ICANS are already established. Despite progress, challenges remain, including long-term side effects such as secondary neoplasms. CAR‑T therapies could potentially be used in the future for solid tumors and immunological diseases.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Neurologische Nebenwirkungen von CAR-T-Zell-Therapien

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月19日

查看全文
  • Tadeja Urbanic Purkart,
  • Michael Khalil

摘要

CAR-T cell therapies are an established immunotherapy for treating refractory or relapsed B‑cell and plasma cell neoplasms. Since 2017, CD19 and BCMA have been utilized as target structures. The manufacturing process involves extracting T cells from patients, genetically modifying them to express a chimeric antigen receptor (CAR) and expanding them ex vivo. Depending on the product used, a necessary lymphodepleting chemotherapy is administered before infusing the modified CAR-T cells to specifically recognize and destroy tumor cells. The fourth generation CARs enhances the immune response through cytokine release and interaction with the tumor microenvironment. Advances such as dual- or multi-CARs enable the simultaneous recognition of multiple antigens, overcoming resistance. However, despite promising success, side effects like cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) occur. CRS typically begins within a few days after infusion as an acute or subacute condition with fever and other symptoms, and in severe cases, can cause organ dysfunction. ICANS manifests as encephalopathy with neurological symptoms and can occur with or without preceding CRS. The pathogenesis of CRS and ICANS involves several phases: from tumor cell recognition, through cytokine release and systemic inflammatory reaction, to the migration of CAR-T cells into the central nervous system and, ultimately, the resolution of inflammation. Algorithms for the diagnosis and therapy of CRS and ICANS are already established. Despite progress, challenges remain, including long-term side effects such as secondary neoplasms. CAR‑T therapies could potentially be used in the future for solid tumors and immunological diseases.