Chimeric Antigen Receptor T Cells: Toxicity and Management Considerations

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).

Objectives

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

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.

Disclosure

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.

Accreditation

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California State Board of Nursing (CBRN), California Provider number CEP 1036. This activity is approved for 1.00 contact hours.

AACN programming meets the standards for most states that require mandatory continuing education contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.

Refund Policy

Continuing Education Activities are nonrefundable.