Challenges and innovations in managing cytokine release syndrome in CAR-T therapy: mechanisms, clinical impact, and future directions

Chimeric Antigen Receptor (CAR) T-cell treatment represents a groundbreaking advancement in cancer immunotherapy, particularly for blood-related cancers. Nevertheless, its therapeutic application is sometimes hindered by Cytokine Release Syndrome (CRS), an inflammatory response that has the potential to be life-threatening. This review explores the underlying causes of CRS, its clinical symptoms, and the difficulties encountered in treating affected people. In addition, we investigate contemporary treatment methods, such as administering tocilizumab and utilizing kinase inhibitors and CAR-NK cells, to mitigate the severity of CRS while maintaining the effectiveness of CAR-T cell therapy. In addition, we emphasize upcoming advancements in CAR-T technology, including reversible and irreversible CAR switches, which are intended to improve both safety and therapeutic results. This study emphasizes the continuous requirement for research to enhance CAR-T cell treatment by finding a middle ground between optimizing its effectiveness and guaranteeing patient safety.