Diagnosis, grading and management of toxicities from immunotherapies in children, adolescents and young adults with cancer

Dristhi Ragoonanan, Sajad J. Khazal, Hisham Abdel-Azim, David McCall, Branko Cuglievan, Francesco Paolo Tambaro, Ali Haider Ahmad, Courtney M. Rowan, Cristina Gutierrez, Keri Schadler, Shulin Li, Matteo Di Nardo, Linda Chi, Alison M. Gulbis, Basirat Shoberu, Maria E. Mireles, Jennifer McArthur, Neena Kapoor, Jeffrey Miller, Julie C. FitzgeraldPriti Tewari, Demetrios Petropoulos, Jonathan B. Gill, Christine N. Duncan, Leslie E. Lehmann, Sangeeta Hingorani, Joseph R. Angelo, Rita D. Swinford, Marie E. Steiner, Fiorela N. Hernandez Tejada, Paul L. Martin, Jeffery Auletta, Sung Won Choi, Rajinder Bajwa, Natalie Dailey Garnes, Partow Kebriaei, Katayoun Rezvani, William G. Wierda, Sattva S. Neelapu, Elizabeth J. Shpall, Selim Corbacioglu, Kris M. Mahadeo

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

Cancer immunotherapies are associated with remarkable therapeutic response rates but also with unique and severe toxicities, which potentially result in rapid deterioration in health. The number of clinical applications for novel immune effector-cell therapies, including chimeric antigen receptor (CAR)-expressing cells, and other immunotherapies, such as immune-checkpoint inhibitors, is increasing. In this Consensus Statement, members of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Hematopoietic Cell Transplantation-Cancer Immunotherapy (HCT-CI) Subgroup, Paediatric Diseases Working Party (PDWP) of the European Society of Blood and Marrow Transplantation (EBMT), Supportive Care Committee of the Pediatric Transplantation and Cellular Therapy Consortium (PTCTC) and MD Anderson Cancer Center CAR T Cell Therapy-Associated Toxicity (CARTOX) Program collaborated to provide updated comprehensive recommendations for the care of children, adolescents and young adults receiving cancer immunotherapies. With these recommendations, we address emerging toxicity mitigation strategies, we advocate for the characterization of baseline organ function according to age and discipline-specific criteria, we recommend early critical care assessment when indicated, with consideration of reversibility of underlying pathology (instead of organ failure scores) to guide critical care interventions, and we call for researchers, regulatory agencies and sponsors to support and facilitate early inclusion of young patients with cancer in well-designed clinical trials.

Original languageEnglish (US)
Pages (from-to)435-453
Number of pages19
JournalNature Reviews Clinical Oncology
Volume18
Issue number7
DOIs
StatePublished - Jul 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Fingerprint

Dive into the research topics of 'Diagnosis, grading and management of toxicities from immunotherapies in children, adolescents and young adults with cancer'. Together they form a unique fingerprint.

Cite this