Cardiovascular toxicities associated with novel cellular immune therapies

Abstract: Over the past decade, T-cell–directed therapies, including chimeric antigen receptor T-cell (CAR-T) and bispecific T-cell engager (BTE) therapies, have reshaped the treatment of an expanding number of hematologic malignancies, whereas tumor-infiltrating lymphocytes, a recently approved cel...

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Main Authors: Malak Munir, Ahmed Sayed, Daniel Addison, Narendranath Epperla
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952924006141
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author Malak Munir
Ahmed Sayed
Daniel Addison
Narendranath Epperla
author_facet Malak Munir
Ahmed Sayed
Daniel Addison
Narendranath Epperla
author_sort Malak Munir
collection DOAJ
description Abstract: Over the past decade, T-cell–directed therapies, including chimeric antigen receptor T-cell (CAR-T) and bispecific T-cell engager (BTE) therapies, have reshaped the treatment of an expanding number of hematologic malignancies, whereas tumor-infiltrating lymphocytes, a recently approved cellular therapy, targets solid tumor malignancies. Emerging data suggest that these therapies may be associated with a high incidence of serious cardiovascular toxicities, including atrial fibrillation, heart failure, ventricular arrhythmias, and other cardiovascular toxicities. The development of these events is a major limitation to long-term survival after these treatments. This review examines the current state of evidence, including reported incidence rates, risk factors, mechanisms, and management strategies of cardiovascular toxicities after treatment with these novel therapies. We specifically focus on CAR-T and BTE therapies and their relation to arrhythmia, heart failure, myocarditis, bleeding, and other major cardiovascular events. Beyond the relationship between cytokine release syndrome and cardiotoxicity, we describe other potential mechanisms and highlight key unanswered questions and future directions of research.
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spelling doaj-art-4ad338e1530548499095c9767a94dea82025-08-20T02:38:17ZengElsevierBlood Advances2473-95292024-12-018246282629610.1182/bloodadvances.2024013849Cardiovascular toxicities associated with novel cellular immune therapiesMalak Munir0Ahmed Sayed1Daniel Addison2Narendranath Epperla3Department of Medicine, Ain Shams University Faculty of Medicine, Cairo, EgyptDepartment of Medicine, Ain Shams University Faculty of Medicine, Cairo, Egypt; Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TXDivision of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH; Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OHDivision of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT; Correspondence: Narendranath Epperla, Division of Hematology and Hematologic Malignancies, Department of Medicine, Huntsman Cancer Institute, Salt Lake City, UT 84103;Abstract: Over the past decade, T-cell–directed therapies, including chimeric antigen receptor T-cell (CAR-T) and bispecific T-cell engager (BTE) therapies, have reshaped the treatment of an expanding number of hematologic malignancies, whereas tumor-infiltrating lymphocytes, a recently approved cellular therapy, targets solid tumor malignancies. Emerging data suggest that these therapies may be associated with a high incidence of serious cardiovascular toxicities, including atrial fibrillation, heart failure, ventricular arrhythmias, and other cardiovascular toxicities. The development of these events is a major limitation to long-term survival after these treatments. This review examines the current state of evidence, including reported incidence rates, risk factors, mechanisms, and management strategies of cardiovascular toxicities after treatment with these novel therapies. We specifically focus on CAR-T and BTE therapies and their relation to arrhythmia, heart failure, myocarditis, bleeding, and other major cardiovascular events. Beyond the relationship between cytokine release syndrome and cardiotoxicity, we describe other potential mechanisms and highlight key unanswered questions and future directions of research.http://www.sciencedirect.com/science/article/pii/S2473952924006141
spellingShingle Malak Munir
Ahmed Sayed
Daniel Addison
Narendranath Epperla
Cardiovascular toxicities associated with novel cellular immune therapies
Blood Advances
title Cardiovascular toxicities associated with novel cellular immune therapies
title_full Cardiovascular toxicities associated with novel cellular immune therapies
title_fullStr Cardiovascular toxicities associated with novel cellular immune therapies
title_full_unstemmed Cardiovascular toxicities associated with novel cellular immune therapies
title_short Cardiovascular toxicities associated with novel cellular immune therapies
title_sort cardiovascular toxicities associated with novel cellular immune therapies
url http://www.sciencedirect.com/science/article/pii/S2473952924006141
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