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Biomarkers of cytokine release syndrome and neurotoxicity related to CAR-T cell therapy

机译:与CAR-T细胞疗法有关的细胞因子释放综合征和神经毒性的生物标志物

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AbstractSevere cytokine release syndrome (CRS) and neurotoxicity following chimeric antigen receptor T cell (CAR-T) therapy can be life-threatening in some cases, and management of those toxicities is still a great challenge for physicians. Researchers hope to understand the pathophysiology of CRS and neurotoxicity, and identify predictive biomarkers that can forecast those toxicities in advance. Some risk factors for severe CRS and/or neurotoxicity including patient and treatment characteristics have been identified in multiple clinical trials of CAR-T cell therapy. Moreover, several groups have identified some predictive biomarkers that are able to determine beforehand which patients may suffer severe CRS and/or neurotoxicity during CAR-T cell therapy, facilitating testing of early intervention strategies for those toxicities. However, further studies are needed to better understand the biology and related risk factors for CRS and/or neurotoxicity, and determine if those identified predictors can be extrapolated to other series. Herein, we review the pathophysiology of CRS and neurotoxicity, and summarize the progress of predictive biomarkers to improve CAR-T cell therapy in cancer.
机译:摘要嵌合抗原受体T细胞(CAR-T)治疗后的严重细胞因子释放综合征(CRS)和神经毒性在某些情况下可能会危及生命,而对这些毒性的管理仍是医师的一大挑战。研究人员希望了解CRS和神经毒性的病理生理,并确定可以提前预测这些毒性的预测性生物标志物。在CAR-T细胞疗法的多项临床试验中已经确定了严重CRS和/或神经毒性的一些风险因素,包括患者和治疗特征。此外,几个小组已经确定了一些预测性生物标志物,能够预先确定哪些患者在CAR-T细胞治疗期间可能遭受严重的CRS和/或神经毒性,从而有助于测试这些毒性的早期干预策略。但是,需要进行进一步的研究,以更好地了解CRS和/或神经毒性的生物学和相关危险因素,并确定是否可以将这些确定的预测因子外推至其他系列。本文中,我们回顾了CRS的病理生理学和神经毒性,并总结了预测性生物标志物改善癌症CAR-T细胞疗法的进展。

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