Rescue Therapies (Tadekinig Alfa) for CAR T cell Related Cytokine Release Syndrome or HLH-like Syndrome
This phase I trial studies the safety of experimental rescue therapies (tadekinig alfa) in treating patients with cytokine release syndrome (CRS) or CAR T cell related hemophagocytic lymphohistiocytosis-like (HLH-like) syndrome (CRHLS). CRS and CRHLS are both life-threatening side effects which can occur in some patients after CAR T cell therapy. CAR T cell th erapy is a type of treatment in which a patient's T cells (a type of immune system cell) are changed in the laboratory so they will attack cancer cells. T cells are taken from a patient’s blood. Then the gene for a special receptor that binds to a certain protein on the patient’s cancer cells is added to the T cells in the laboratory. The special receptor is called a chimeric antigen receptor (CAR). Large numbers of the CAR T cells are grown in the laboratory and given to the patient by infusion for treatment of certain cancers . Cytokine release syndrome is caused by a large, rapid release of cytokines into the blood from immune cells affected by the immunotherapy. Cytokines are immune substances that have many different actions in the body. Signs and symptoms of cytokine release syndrome include fever, nausea, headache, rash, rapid heartbeat, low blood pressure, and trouble breathing. CRHLS is a syndrome which causes inflammation and organ dysfunction in the setting of cytokine release syndrome, which is thought to be caused by the rapid expansion of the infused T cells. CRHLS has rarely occurred separately from CRS, but if/when it occurs, the side effects/symptoms are similar to that of CRS. Symptoms may include: changes in blood counts, increased risk of bleeding, and liver and kidney problems. CAR T cell therapy may result in development of symptoms that are similar to HLH.Tadekinig alfa is a binding protein rescue therapy drug which may help improve CRS and CRHLS symptoms by binding to a specific inflammatory cytokine thereby reducing inflammation. This medication would be given in addition to routine care therapies used for the treatment of these CAR T cell therapy side effects.