嵌合抗原受体T细胞疗法CRS/ICANS反应的ASTCT共识解读

Interpretation of ASTCT Consensus Responses by Chimeric Antigen Receptor T Cell Therapy CRS/ICANS——Review

嵌合抗原受体T细胞疗法被美国临床肿瘤学会评为2017年最大的研究突破,现正迅速成为治疗血液学恶性肿瘤最有前途的一项新疗法,但同时也带来了新的挑战——细胞因子释放综合征和神经毒性等,有时甚至会引起患者的死亡。在不同的多中心试验报告中,以上毒性事件的发生率和严重程度也不尽相同,究其原因是对毒性的评估和分级在不同的临床试验和机构间存在很大差异。2018年发布的ASTCT共识提出了免疫效应细胞相关的细胞因子释放综合征和神经毒性的分级,本文就该共识的主要内容进行解读,以期为我国该领域相关工作的开展及安全性策略的制定提供参考。

Chimeric antigen receptor T cell(CAR-T) therapy was awarded as the largest research breakthrough in2017 by the American Society of Clinical Oncology, at present, it is rapidly becoming the most promising new treatment for hematological malignancies. However, this therapy also produces a new challenge: toxic adverse events such as cytokine release syndrome(CRS) and neurotoxicity, partial of them can bring death to the patients. The incidence and severity of the above toxic events in different multi-center trial reports are also different, which may be attributed to the different in the considerably variable assessment and grading of toxicities between clinical trials and across institutions.The ASTCT published at 2018 advanced the consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells, it was focusing on CRS and neurotoxicity associated with immune effector cells.In order to provide reference for the development of relevant work in this field and the formulation of security strategies in our country, the main content of the consensus was summarized briefly.