Neurotoxicity and CAR T-Cell Treatment
What is CAR T-cell therapy?
CAR T-cell therapy is a treatment that takes T-cells from your blood, changes them in a lab, and then puts them back in your body. T-cells are immune system cells that can be altered in a lab so that they attack cancer cells. Your T-cells are changed so that they have a special receptor on them that binds to certain proteins on cancer cells. This receptor is called chimeric antigen receptor, or CAR. These CAR T-cells are grown in a lab and then infused back into your body to attack cancer cells.
What is neurotoxicity?
Neurotoxicity is damage to your brain and nervous system. Neurotoxicity can be caused by a number of toxins such as:
- Exposure to some heavy metals.
- Illicit drugs.
The signs and symptoms you have depend on the cause of your neurotoxicity. Signs and symptoms can happen right away or can happen years later. Every person’s experience with neurotoxicity is different.
Neurotoxicity and CAR T-cell Therapy
Neurotoxicity can be a side effect of CAR T-cell therapy. There are still a lot of unknowns about how CAR T-cell therapy causes neurotoxicity and why only some patients are affected by it. This is because it is a newer treatment and research continues to better understand this issue. Some symptoms of neurotoxicity related to CAR T-cell therapy are:
- General weakness.
- Changes in thinking.
- Balance issues.
- Brain swelling.
Symptoms vary from patient to patient and can range from mild to severe.
How is neurotoxicity related to CAR T-cell therapy treated?
There is no specific treatment for neurotoxicity caused by CAR T-cell therapy. Your symptoms will be managed using medication and other therapies. In most cases, your neurotoxicity symptoms will resolve in about 21 days. Corticosteroids, which decrease inflammation, can be used to decrease swelling in your brain. However, treatment with high doses of corticosteroids can interfere with how your T-cells work. Your provider will decide what course of treatment is right for you.
Any changes in how you think, walk, talk, or have new or worsening headaches are always a reason to contact your provider. If you have recently been treated with CAR T-cell therapy and you have any new symptoms related to neurotoxicity, contact your provider right away.
Shabir, O. 2020. Neurotoxic Side Effects of CAR T-Cell Therapy. News Medical Life Sciences. https://www.news-medical.net/health/Neurotoxic-Side-Effects-of-CAR-T-Cell-Therapy.aspx
Seattle Children’s Hospital. Neurotoxicity in Pediatric Cancer Treatment. https://www.seattlechildrens.org/research/centers-programs/science-industry-partnerships/partnership-opportunities/cancer-neurotoxicity/#:~:text=Although%20patients%20have%20shown%20dramatic,from%20mild%20to%20potentially%20fatal.
Belin, C. et al. 2020. Description of neurotoxicity in a series of patients treated with CAR T-cell therapy. Scientific Reports. https://www.nature.com/articles/s41598-020-76055-9
National Cancer Institute. CAR T-cell therapy. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/car-t-cell-therapy