Cardiotoxicities of Chimeric Antigen Receptor T-Cell Therapy and Bispecific T-Cell Antibodies

Chimeric antigen receptor T-cells (CAR-T) and bispecific antibodies (BiTE) are novel therapies used to treat hematologic malignancies, lung cancer and melanoma. With the increasing use of these novel therapies, the incidence and prognosis of their cardiovascular side effects needs to be further elucidated.

Randomized trials have highlighted the systemic effects of CAR-T and BiTE therapy including cytokine release syndrome (CRS) and resultant hypotension and respiratory failure. Cohort studies have elucidated the cardiovascular effects associated with CAR-T and BiTE therapy including heart failure, cardiomyopathy, arrythmia, myocardial infarction, stroke and cardiovascular death.

Cardiovascular events after CAR-T and BiTE therapy can occur and are often associated with CRS. CAR-T recipients experiencing severe cardiovascular events may have worse survival. Further prospective studies are needed to understand the full scope of cardiovascular effects and mitigation strategies for these therapies.