College
College of Arts and Sciences
Mentor Information
Sahana Rajasekhara
Description
Chimeric Antigen Receptor T-cell therapy (CAR T-cell), combination CAR-T-cell strategies, and conventional chemotherapy demonstrate distinct relapse patterns and toxicity profiles in B-cell malignancies. CAR T-cell therapies achieve strong remission rates and toxicities. This review compares relapse outcomes and treatment-related toxicities across those varied approaches to B-cell malignancies, asking how toxicity profiles differ among these modalities, including immune-mediated side effects. A systematic search in PubMed (National Library of Medicine), Google Scholar, ScienceDirect, and EBSCO was carried out to contrast results of CAR T-cell therapy regarding outcomes, rates of relapse and re-emergence, and toxicities relative to cancer therapies. A total of 88 articles were considered in this systematic review that were published from 2015 to 2025. Of which, 48 articles were considered to have met inclusion criteria. The articles were excluded based on factors that included no direct comparison to CAR T-cell therapy or no measure of at least one of the predefined outcomes regarding rates of re-emergence, rates of relapse, rates of cytokine release syndrome, or ICANS. Cytokine release syndrome (CRS) was frequently reported across CAR T-cell studies. Of the 23 articles identifying CRS, only one study reported a low-level (grade 1-2) CRS incidence less than 1%. 15 articles reported low-level CRS in more than 50% of patients. Severe CRS (grade ≥3) was reported in 8 articles, indicating that while severe CRS is less common than low level CRS, it still occurs in approximately 34% of CAR-T therapies. In nearly all cases, severe CRS occurred alongside low-level CRS, which was present in 90% (10/11) of therapies reporting both. Thus, CRS, specifically low-level CRS, is a frequent toxicity observed with CAR T-cell therapy. CAR-T cell therapies demonstrate strong remission potential in B-cell malignancies but are consistently associated with immune- mediated toxicities, particularly CRS. CRS occurs in half of patients who undergo CART cell therapy and can influence their remission rates. Future research should focus on strategies to reduce severe CRS while preserving therapeutic efficacy.
Chimeric Antigen Receptor (CAR) T-Cell Therapy for B-Cell Malignancies: A Systematic Review
Chimeric Antigen Receptor T-cell therapy (CAR T-cell), combination CAR-T-cell strategies, and conventional chemotherapy demonstrate distinct relapse patterns and toxicity profiles in B-cell malignancies. CAR T-cell therapies achieve strong remission rates and toxicities. This review compares relapse outcomes and treatment-related toxicities across those varied approaches to B-cell malignancies, asking how toxicity profiles differ among these modalities, including immune-mediated side effects. A systematic search in PubMed (National Library of Medicine), Google Scholar, ScienceDirect, and EBSCO was carried out to contrast results of CAR T-cell therapy regarding outcomes, rates of relapse and re-emergence, and toxicities relative to cancer therapies. A total of 88 articles were considered in this systematic review that were published from 2015 to 2025. Of which, 48 articles were considered to have met inclusion criteria. The articles were excluded based on factors that included no direct comparison to CAR T-cell therapy or no measure of at least one of the predefined outcomes regarding rates of re-emergence, rates of relapse, rates of cytokine release syndrome, or ICANS. Cytokine release syndrome (CRS) was frequently reported across CAR T-cell studies. Of the 23 articles identifying CRS, only one study reported a low-level (grade 1-2) CRS incidence less than 1%. 15 articles reported low-level CRS in more than 50% of patients. Severe CRS (grade ≥3) was reported in 8 articles, indicating that while severe CRS is less common than low level CRS, it still occurs in approximately 34% of CAR-T therapies. In nearly all cases, severe CRS occurred alongside low-level CRS, which was present in 90% (10/11) of therapies reporting both. Thus, CRS, specifically low-level CRS, is a frequent toxicity observed with CAR T-cell therapy. CAR-T cell therapies demonstrate strong remission potential in B-cell malignancies but are consistently associated with immune- mediated toxicities, particularly CRS. CRS occurs in half of patients who undergo CART cell therapy and can influence their remission rates. Future research should focus on strategies to reduce severe CRS while preserving therapeutic efficacy.
