Cardiovascular Toxicities of CAR T-cell Therapy

Curr Oncol Rep. 2021 May 3;23(7):78. doi: 10.1007/s11912-021-01068-0.

Abstract

Purpose of review: This review provides a contemporary overview of current studies outlining the incidence and characteristics of CAR T-cell cardiotoxicity in an effort to identify future directions for research and potential opportunities for prevention and intervention.

Recent findings: Cardiovascular events occurred in anywhere between 10 and 36% of patients in CAR T-cell clinical trials, ranging from tachycardia, hypotension, arrhythmia, decreased left ventricular systolic function to cardiogenic shock and death. Cardiac events are more often associated higher grades (> 2) of cytokine release syndrome and frequently proceeded by an elevated troponin. There is a growing recognition of cardiotoxicities of CAR T-cell therapy but has a limited study in this area. The mechanism of left ventricular dysfunction due to CAR T-cell therapy is also unknown. As CAR T-cell use expands, it becomes imperative to truly understand the mechanism behind cardiac injury and to assess long-term follow-up data as this will allow for surveillance, early intervention, and potentially prevention of cardiotoxicity.

Keywords: CAR T-cell; Cardio-oncology; Cardiotoxicity; Chimeric antigen receptor; Cytokine release syndrome.

Publication types

  • Review

MeSH terms

  • Cardiotoxicity / etiology
  • Cardiovascular Diseases / etiology*
  • Cytokine Release Syndrome / etiology
  • Humans
  • Immunotherapy, Adoptive / adverse effects*
  • Receptors, Chimeric Antigen / immunology*
  • Ventricular Dysfunction, Left / etiology

Substances

  • Receptors, Chimeric Antigen