Henry C Fung, Chair and Professor, Department of Bone Marrow Transplant and Cellular Therapy at Fox Chase Cancer Center, shared a post on X:
“Precision Immunotoxicology in CAR-T Therapy Biology-Driven Management of CRS, ICANS, and IEC-HS.
CAR-T toxicities are evolving from ‘supportive care syndromes’ into a true field of immunotoxicology.
CRS, ICANS, and IEC-HS are overlapping but biologically distinct immune ecosystems involving:
- IL-6 amplification.
- endothelial injury and BBB disruption.
- macrophage hyperactivation.
- IFN-γ driven inflammation.
This explains why:
- Tocilizumab works best for CRS.
- Steroids dominate ICANS.
- Anakinra and ruxolitinib are increasingly important in HLH-like toxicities.
The future is not one-size-fits-all cytokine suppression. The future is precision biology-driven toxicity management.”
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