Palliative Care & Oncology
Chimeric antigen receptor (CAR) T-cell therapy is a promising novel T-cell immunotherapy, acting as a “living drug” in cancer treatment. It has demonstrated notable clinical efficacy in treating relapsed and refractory disease and is heralded as a major breakthrough in cancer treatment.1Despite its rapidly escalating and widespread use, CAR T-cell therapy is associated with severe and even life-threatening immune-mediated toxicities: cytokine release syndrome (CRS) and CAR T-cell-related encephalopathy syndrome (CRES), for which CL psychiatrists (CLP) are often consulted.2CRES is a neurotoxicity, or toxic encephalopathy, associated with CAR T-cell therapy that can occur with CRS or independently. As CLPs, the future of our sub-specialty is dependent on us remaining not only clinically competent in the care of these complex patients but also in developing specialized expertise regarding the diagnosis, treatment, and likely etiologies of these serious neurotoxic and behavioral disturbances.3
This course offers a targeted, CL-relevant educational foray into the latest in modern cellular cancer therapy. It brings together presenters from multiple levels of training and differing vantage points, yet all with demonstrated expertise in psycho-oncology and CAR T-cell therapy. We will explain – in CL-relevant terms – the definitions, biology, and pathophysiology of CAR T-cell therapy along with its neurotoxicities and treatment. We will also discuss opportunities for a collaborative, interdisciplinary team approach to management, with emphasis specific cases and on the role for CLP. Our goal is to present relevant information for general and hospital-based CLP who will encounter patients in a variety of settings who have received this novel therapy, as well as psycho-oncologists looking to sharpen their skills and knowledge base. We will utilize an interactive polling system to test audience knowledge.This SIG Mentorship Track Symposium is sponsored by the Psycho-Oncology/Palliative Care SIG.
Jessica Molinaro, MD (PGY-4, rising CL Fellow; Medical College of Wisconsin ([MCW]) – Introduction and definitions of CAR T and its associated toxicities
Jennifer Knight, MD, MS, FAPM (Mid-Career Faculty, MCW) – Pathophysiology and future implications of CAR T neuropsychiatric toxicities
Deepa Pawar, MD, MPH (Early Career Faculty; MCW) – CAR T neurotoxicity treatment withcase integration
Sheila Lahijani, MD (Early Career Faculty; Stanford University) – Cross-collaboration in CAR T treatment and the role of the CL psychiatrist