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Cytokine Release Syndrome (CRS) and CAR-T
Cytokine release syndrome (CRS) is the most common side effect of CAR-T therapy and according to the study linked below, CRS occurs in more than 60% of patients while more than 10% of those dying within 30 days of their CRS.
CRS is:
What happens to the patient when they get cytokine release syndrome?
- Fever: One of the first and most common symptoms is a high fever. This is a result of the body’s inflammatory response.
- Fatigue and Malaise: Patients often feel extremely tired and unwell.
- Hypotension (Low Blood Pressure): Due to the widespread inflammation and the effects on blood vessels, patients may experience low blood pressure, which can be severe and require medication to manage.
- Difficulty Breathing: The inflammation can affect the lungs, leading to difficulty breathing and requiring oxygen support or even mechanical ventilation in severe cases.
- Organ Dysfunction: CRS can lead to dysfunction of multiple organs, including the heart, kidneys, liver, and central nervous system. This can manifest as altered mental status, arrhythmias, kidney failure, and liver dysfunction.
- Elevated Heart Rate: Tachycardia (an abnormally rapid heart rate) is common due to the body’s inflammatory response and the need to maintain blood pressure.
- Increased Risk of Infection: The immune system’s hyperactivation can paradoxically lead to an increased risk of infections.
- Coagulopathy: CRS can affect the blood’s ability to clot properly, leading to either increased risk of bleeding or clotting complications.
I understand that, where myeloma patients are concerned, therapy options may be limited. In my experience as a MM survivor and cancer coach, I’ve learned that only those MM patients who are triple or quadruple refractory undergo CAR-T therapy.
However, understanding the prevalence and severity of all treatment-inducted adverse events of a given therapy enables the patient to have more say and therefore more control over those therapies that he/she undergoes.
Could integrative MM therapies be used before CAR-T therapy? Something to consider. If you would like to learn more about evidence-based non-conventional MM therapies email me at David.PeopleBeatingCancer@gmail.com
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Large Data Set Sheds Light on Rate of CAR-T Side Effects
“Cytokine release syndrome (CRS) is the most commonly observed adverse event associated with chimeric antigen receptor T-cell (CAR-T) therapy. However, true rates of CRS have been difficult to ascertain due to the small sample sizes of CAR-T therapy clinical trials. A new analysis based on Medicare data may offer a more reliable picture of CRS occurrence—and road map for strategies to prevent it…
“We can now have confidence in the rate of CRS occurrence since we have significant enough volume of CAR-T cases within Medicare that the outliers are no longer significantly influencing the result…”
To conduct the analysis, ADVI assessed 2,733 CAR-T cases covered by Medicare dating back to the third quarter of 2020 through the fourth quarter of 2022. Overall, 1,870 patients (68%) experienced CRS, and 204 (11%) died within three months of experiencing CRS. The rate of CRS was significantly lower for beneficiaries receiving CAR-T as outpatients compared with the inpatient setting (57% vs. 69%)…
The indications for CAR-T therapy are more common in the older, Medicare-aged population than in younger patients. The mean age of participants in this retrospective study was 70 years, and more than two-thirds (1,956) received their treatment in nonclinical trial settings, potentially offering a representative picture of people who get the procedure and may experience CRS in real-world settings…
The analysis assessed CRS rates and outcomes but neither compared the costs of CRS and non-CRS cases, nor the cost of other downstream CRS-related treatment. “The reason we did not include costs associated [with CRS] was that the data source for the Medicare Advantage claims used in this analysis did not have reimbursement information included,” Mr. Kardel explained. However, he noted that studying the financial implications of CRS is an important next step in this line of research…”