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 complete the entire activity and the associated evaluation to be awarded contact hours AND read Implicit Bias impacts patient outcomes. No partial credit will be awarded.

Accreditation

The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
Provider approved by the California Board of Registered Nursing, Provider number CEP 1036, for {contactHours} contact hours.

Disclosures

Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content will be identified by the Nurse Planner within the activity. Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content has been mitigated.

Accreditation refers to recognition of continuing education only and does not imply AACN, ANCC, or CBRN approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity. Activities with pharmacology hours are to assist the APRN in fulfilling the pharmacotherapeutic education requirements for licensure and certification renewals.

Activities meet the standards for most states that require mandatory continuing education for license and/or certification renewal. AACN recommends consulting with your own state board of nursing or credentialing organization before submitting your certificate of completion.

Refund Policy

Continuing Education Activities are nonrefundable.