Ready or Not, Here They Come: A Practical Guide to Adoptive T cell Therapies for Solid Tumors for Medical Oncologists

Adoptive cell therapies (ACTs) include chimeric antigen receptors (CARs), bispecific T cell engagers (BiTES), tumor infiltrating lymphocytes (TILs) and T cell receptor (TCR) gene modified T cells. ACTs have significantly improved patient outcomes associated with hematologic malignancies. Recent advances have demonstrated their potential in solid tumors with promising clinical trial results signaling that they represent paradigm shift in oncologic care. As these therapies become standard care in solid tumors, medical oncologists must become adept at recognizing and managing their unique toxicities including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). This review synthesizes the latest clinical data on ACTs in solid tumors, highlighting key findings and toxicity profiles. In addition, the review provides an overview of early recognition and evidence-based management of CRS and ICANS. Equipping clinicians with the necessary knowledge to navigate toxicity management will be essential in optimizing patient outcomes as ACTs are increasingly adopted in solid tumor oncology.