Immune-Related Adverse Events Induced by Immune Checkpoint Inhibitors and CAR-T Cell Therapy: A Comprehensive Imaging-Based Review.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_21C90DDD7652
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Immune-Related Adverse Events Induced by Immune Checkpoint Inhibitors and CAR-T Cell Therapy: A Comprehensive Imaging-Based Review.
Journal
Cancers
Author(s)
Pozzessere C., Mazini B., Omoumi P., Jreige M., Noirez L., Digklia A., Fasquelle F., Sempoux C., Dromain C.
ISSN
2072-6694 (Print)
ISSN-L
2072-6694
Publication state
Published
Issued date
19/07/2024
Peer-reviewed
Oui
Volume
16
Number
14
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
Immunotherapy has revolutionized oncology care, improving patient outcomes in several cancers. However, these therapies are also associated with typical immune-related adverse events due to the enhanced inflammatory and immune response. These toxicities can arise at any time during treatment but are more frequent within the first few months. Any organ and tissue can be affected, ranging from mild to life-threatening. While some manifestations are common and more often mild, such as dermatitis and colitis, others are rarer and more severe, such as myocarditis. Management depends on the severity, with treatment being held for >grade 2 toxicities. Steroids are used in more severe cases, and immunosuppressive treatment may be considered for non-responsive toxicities, along with specific organ support. A multidisciplinary approach is mandatory for prompt identification and management. The diagnosis is primarily of exclusion. It often relies on imaging features, and, when possible, cytologic and/or pathological analyses are performed for confirmation. In case of clinical suspicion, imaging is required to assess the presence, extent, and features of abnormalities and to evoke and rule out differential diagnoses. This imaging-based review illustrates the diverse system-specific toxicities associated with immune checkpoint inhibitors and chimeric antigen receptor T-cells with a multidisciplinary perspective. Clinical characteristics, imaging features, cytological and histological patterns, as well as the management approach, are presented with insights into radiological tips to distinguish these toxicities from the most important differential diagnoses and mimickers-including tumor progression, pseudoprogression, inflammation, and infection-to guide imaging and clinical specialists in the pathway of diagnosing immune-related adverse events.
Keywords
CAR T-cell therapy, computed tomography, imaging, immune checkpoint inhibitors, immune-related adverse event, immunotherapy, magnetic resonance imaging, medical oncology, positron emission tomography/computed tomography, toxicity
Pubmed
Web of science
Open Access
Yes
Create date
29/07/2024 8:25
Last modification date
20/08/2024 6:23
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