Key points:


• Understanding CAR T cell therapy and its application in hematologic malignancies and solid tumors.
• Mechanism of action: How CAR T cells are engineered to target cancer cells.
• Acute side effects: Cytokine release syndrome (CRS) and neurotoxicity, including clinical pearls for management.
• Chronic side effects: Monitoring for infections, cytopenias, and the risk of secondary malignancies.
• The importance of bridging therapy and managing tumor burden before CAR T treatment.
• Insights for community oncologists on patient management and communication with CAR T centers.
In this episode of the Oncology Brothers podcast, we delve into the rapidly evolving field of CAR T cell therapy, a groundbreaking treatment for various hematologic malignancies. Co-hosts Drs. Rahul and Rohit Gosain, are joined by esteemed experts Dr. Surbhi Sidana from Stanford University and Dr. Jason Westin from MD Anderson Cancer Center.
We begin by discussing the mechanism of action of CAR T cell therapy, where patients' lymphocytes are engineered to target specific proteins on cancer cells, such as CD19 for lymphoma and BCMA for myeloma. This innovative approach transforms ordinary immune cells into an elite fighting force against cancer, leading to significant side effects due to the robust immune response.
The conversation then shifts to the acute side effects associated with CAR T therapy, particularly cytokine release syndrome (CRS) and neurotoxicity. Drs. Sidana and Westin provide insights into the management of these side effects, emphasizing the importance of recognizing symptoms early and the role of community oncologists in patient care.
We also explore the impact of tumor burden on the severity of side effects, with both experts agreeing that higher tumor loads can lead to more pronounced adverse events. Bridging therapies to reduce tumor burden before CAR T administration are discussed as a critical strategy.
As we transition to chronic side effects, we highlight the risks of infections, particularly pneumocystis pneumonia and zoster, and the importance of prophylactic measures. The need for ongoing monitoring for secondary malignancies and other long-term complications is underscored, as we continue to learn about the late effects of CAR T therapy.
In closing, we stress the importance of communication between community oncologists and CAR T centers to ensure comprehensive patient care. This episode serves as a vital resource for understanding the complexities of CAR T therapy, its side effects, and the collaborative approach needed to manage these patients effectively. Thank you for joining us, and we hope you find this discussion enlightening as we navigate the future of oncology together.