CAR T-Cell Therapy Made Ridiculously Simple
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CAR T-Cell Therapy Made Ridiculously Simple Saba Shaikh, MD Hematology/Oncology
Transcript of CAR T-Cell Therapy Made Ridiculously Simple
CAR T-Cell TherapyMade Ridiculously Simple
Saba Shaikh, MD
Hematology/Oncology
Learner objectives for this talk
• Understand CAR-T mechanism of action
• Identify treatment indications
• Recognize unique toxicities and key management principles
Before After
Modify T cells to better detect cancer antigens
(Chimeric Antigen Receptor)
T cells are extracted from the patient’s blood
T
T cells are re-engineered into CAR T-cells And multiplied
Patient receives chemotherapy to kill their own lymphocytes to make space for the cells
• Relapsed/refractory B-cell lymphomas
• Relapsed Acute lymphoblastic leukemia (ALL)
500+ clinical trials!
• Multiple myeloma
• Acute myeloid leukemia (AML)
• Pancreatic cancer
Unique Toxicities
Cytokine Release Syndrome
IL-6IFNy
IL-8
FEVER
HYPOXIA
HYPOTENSION
END ORGAN DAMAGE
SOMNOLENCE CONFUSION APHASIA
Neurotoxicity
Key Management Principles
CRS Severe CRS Neurotoxicity
fluids, Tylenol, infectious work up & antibiotics
+ tocilizumab (anti-IL6)+ Steroids
EEG, MRI, seizure prophylaxis+/- steroids
Take home points
Re-engineered T cell with better specificity for tumor
antigen
Approved for relapsed or refractory B cell lymphoma
or relapsed ALL
Supportive Care+/- tocilizumab
+/- steroids
Disclaimer: images are not my own and were identified through Google image searches
