From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapy

Chimeric antigen receptor T-cell therapy represents an innovative approach to immunotherapy and currently stands out, particularly for oncohematological patients refractory to traditional treatments. Ongoing trials are further expanding its clinical use for new oncological and non-oncological indica...

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Main Authors: Frank Nunes, Breno Moreno de Gusmão, Franciely Bueno Wiginesk, Euler Manenti, Juliana Soares, Mizianne Garcia Freitas, Juliane Dantas Seabra-Garcez, Alexandre Manoel Varela, João Pedro Passos Dutra, Bruno Cesar Bacchiega, Tânia Félix Lorenzato da Fonseca Peixoto, Carolina Maria Pinto Domingues de Carvalho e Silva, Renato D. Lopes, Ariane Vieira Scarlatelli Macedo
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Hematology, Transfusion and Cell Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S2531137924003195
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author Frank Nunes
Breno Moreno de Gusmão
Franciely Bueno Wiginesk
Euler Manenti
Juliana Soares
Mizianne Garcia Freitas
Juliane Dantas Seabra-Garcez
Alexandre Manoel Varela
João Pedro Passos Dutra
Bruno Cesar Bacchiega
Tânia Félix Lorenzato da Fonseca Peixoto
Carolina Maria Pinto Domingues de Carvalho e Silva
Renato D. Lopes
Ariane Vieira Scarlatelli Macedo
author_facet Frank Nunes
Breno Moreno de Gusmão
Franciely Bueno Wiginesk
Euler Manenti
Juliana Soares
Mizianne Garcia Freitas
Juliane Dantas Seabra-Garcez
Alexandre Manoel Varela
João Pedro Passos Dutra
Bruno Cesar Bacchiega
Tânia Félix Lorenzato da Fonseca Peixoto
Carolina Maria Pinto Domingues de Carvalho e Silva
Renato D. Lopes
Ariane Vieira Scarlatelli Macedo
author_sort Frank Nunes
collection DOAJ
description Chimeric antigen receptor T-cell therapy represents an innovative approach to immunotherapy and currently stands out, particularly for oncohematological patients refractory to traditional treatments. Ongoing trials are further expanding its clinical use for new oncological and non-oncological indications, potentially leading to newer treatment options soon.This new approach, however, also presents challenges, including cardiovascular toxicity. Little is reported in pivotal studies, and some recent retrospective observations suggest a non-negligible incidence of side effects with presentation ranging from mild adverse cardiovascular events to fatal complications in which, in most cases, there is a direct or indirect association with cytokine release syndrome.In this literature review, the hypotheses of an important interface between cytokine release syndrome and cardiotoxicity by chimeric antigen receptor T-cell therapy will be addressed, as will current knowledge about risk factors for cardiotoxicity and recommendations for pre-therapy evaluation, post-infusion monitoring and clinical management of these complications.
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series Hematology, Transfusion and Cell Therapy
spelling doaj-art-9bbc7a83e2c74db1908d4ccc57de685c2025-08-20T02:56:47ZengElsevierHematology, Transfusion and Cell Therapy2531-13792025-01-0147110369310.1016/j.htct.2024.06.008From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapyFrank Nunes0Breno Moreno de Gusmão1Franciely Bueno Wiginesk2Euler Manenti3Juliana Soares4Mizianne Garcia Freitas5Juliane Dantas Seabra-Garcez6Alexandre Manoel Varela7João Pedro Passos Dutra8Bruno Cesar Bacchiega9Tânia Félix Lorenzato da Fonseca Peixoto10Carolina Maria Pinto Domingues de Carvalho e Silva11Renato D. Lopes12Ariane Vieira Scarlatelli Macedo13Hospital César Leite, Manhuaçu, BrazilHospital BP, São Paulo, BrazilInstituto de Cardiologia Campo Grande, Campo Grande, BrazilInstituto de Medicina Vascular, Hospital Mãe de Deus, Porto Alegre, BrazilHospital Israelita Albert Einstein, São Paulo, BrazilPrefeitura de Campo Grande, Campo Grande, BrazilHospital São Lucas Rede D'Or São Luiz, Aracaju, Brazil; Hospital Primavera, Aracaju, BrazilHospital Universitário Evangélico Mackenzie, Curitiba, Brazil; Complexo Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil; Hospital Erasto Gaertner, Curitiba, BrazilCentro de Pesquisas Oncológicas, Florianópolis, Brazil; Hospital SOS Cárdio, Florianópolis, BrazilBarretos Cancer Hospital, Barretos, BrazilHospital Felício Rocho, Belo Horizonte, BrazilCardioPrime Cardiovascular Center, Ribeirão Preto, BrazilDuke University /Duke Clinical Research Institute, Durham, USAFaculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil; Corresponding author at: Departamento de Medicina, Faculdade de Ciências Médicas Santa Casa de São Paulo, Rua Dr. Cesário da Motta Jr 61, 11 andar- Vila Buarque, CEP: 01221-020 São Paulo, SP, Brazil.Chimeric antigen receptor T-cell therapy represents an innovative approach to immunotherapy and currently stands out, particularly for oncohematological patients refractory to traditional treatments. Ongoing trials are further expanding its clinical use for new oncological and non-oncological indications, potentially leading to newer treatment options soon.This new approach, however, also presents challenges, including cardiovascular toxicity. Little is reported in pivotal studies, and some recent retrospective observations suggest a non-negligible incidence of side effects with presentation ranging from mild adverse cardiovascular events to fatal complications in which, in most cases, there is a direct or indirect association with cytokine release syndrome.In this literature review, the hypotheses of an important interface between cytokine release syndrome and cardiotoxicity by chimeric antigen receptor T-cell therapy will be addressed, as will current knowledge about risk factors for cardiotoxicity and recommendations for pre-therapy evaluation, post-infusion monitoring and clinical management of these complications.http://www.sciencedirect.com/science/article/pii/S2531137924003195CardiotoxicityChimeric antigen receptor therapyCytokine release syndromeCardio-OncologyHematology
spellingShingle Frank Nunes
Breno Moreno de Gusmão
Franciely Bueno Wiginesk
Euler Manenti
Juliana Soares
Mizianne Garcia Freitas
Juliane Dantas Seabra-Garcez
Alexandre Manoel Varela
João Pedro Passos Dutra
Bruno Cesar Bacchiega
Tânia Félix Lorenzato da Fonseca Peixoto
Carolina Maria Pinto Domingues de Carvalho e Silva
Renato D. Lopes
Ariane Vieira Scarlatelli Macedo
From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapy
Hematology, Transfusion and Cell Therapy
Cardiotoxicity
Chimeric antigen receptor therapy
Cytokine release syndrome
Cardio-Oncology
Hematology
title From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapy
title_full From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapy
title_fullStr From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapy
title_full_unstemmed From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapy
title_short From the mechanism of action to clinical management: A review of cardiovascular toxicity in adult treated with CAR-T therapy
title_sort from the mechanism of action to clinical management a review of cardiovascular toxicity in adult treated with car t therapy
topic Cardiotoxicity
Chimeric antigen receptor therapy
Cytokine release syndrome
Cardio-Oncology
Hematology
url http://www.sciencedirect.com/science/article/pii/S2531137924003195
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