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T-Cell Engaging Antibodies: Management of Cytokine Release Syndrome (CRS) and Immune Effector-Associated Neurotoxicity Syndrome (ICANS)

Nov 2024
Type of Content: Guidelines & Advice, Clinical
Document Status: In-Development

Guideline Objective

To provide recommendations and identify considerations around cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in patients receiving T-cell engaging antibody treatment.

Patient Population

Adults receiving treatment with a T-cell engaging antibody.

Intended Guideline Users

Clinicians treating patients receiving a T-cell engaging antibody and/or managing possible toxicities, including CRS and/or ICANS.

Research Questions

  1. What prophylactic measures are needed to help prevent CRS and ICANS?
    • Is there a role for prophylactic tocilizumab?
    • Can the premedications be standardized across T-cell engaging antibodies?
  2. Are there specific patient groups who are at a higher risk of experiencing CRS and ICANS?
  3. What is the appropriate management of CRS based on grade?
  4. What is the appropriate management of ICANS based on grade?
  5. What factors should be taken into consideration for the outpatient administration of ramp-up doses?

The clinical guidance report is under development for release.

If you are a patient, please contact your oncology care team if you have concerns or issues in the interim.