Chimeric Antigen Receptor T Cells: Toxicity and Management Considerations

Author(s): Kent A. Owusu, PharmD, BCPS, BCCCP, FCCM, FNCS, Molly Schiffer, PharmD, BCOP, Sarah Perreault, PharmD, BCPS, BCOP

Contact Hours 1.00

CERP A 1.00

Pharmacology Hours 1.00

Expires Dec 15, 2025

Topics: Hematology/Oncology, Medication Management

Member: Free
NonMember: $10.00

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Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

Chimeric antigen receptor (CAR) T-cell therapies use genetically engineered T cells that mediate T-cell activation and costimulation.1,2 CAR T-cell therapies can produce sustained remission in hematologic malignancies that are refractory to standard therapies. Tisagenlecleucel and axicabtagene ciloleucel are among the first CAR T-cell therapies approved by the US Food and Drug Administration (FDA) for the treatment of acute lymphoblastic leukemia and diffuse large B-cell lymphoma. CAR T-cell therapies are designed to recognize and bind to specific antigens on tumor cells, leading to CAR T-cell {AQ2} activation and proliferation and eventually resulting in significant and durable destruction of malignant cells. However, these therapies can potentially cause destruction of normal, nonmalignant cells when targeting a tumor-associated antigen also expressed on normal cells. Toxicities related to CAR T cells can occur and may include infusion-related reactions, tumor lysis syndrome, infections, cytokine release syndrome (CRS), and immune effector cell–associated neurotoxicity syndrome (ICANS).


  • Describe mechanism of action of chimeric antigen receptor T-cell therapies
  • Identity associated chimeric antigen receptor T-cell toxicities and expected characteristics of toxicities
  • Describe preventative and management strategies of chimeric antigen receptor T-cell toxicities

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Successful Completion

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This activity has been reviewed by the Nurse Planner. It has been determined that the material presented here shows no bias. No conflicts of interest have been identified for any individual with the ability to influence the content of this activity. Accreditation refers to recognition of continuing education only and does not imply AACN or ANCC approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity.


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