CAR-T and cellular therapy toxicities take center stage at major international conference

As CAR-T cell therapy, tumor-infiltrating lymphocyte (TIL) therapy, and other immune effector cell treatments expand into new disease settings and older patient populations, their toxicity profiles are growing more complex. The American Society for Transplantation and Cellular Therapy (ASTCT) is hosting its 5th International Conference on Toxicities of Transplantation and Cellular Therapies on Nov. 13–14 in Chicago, bringing together specialists from hematology, oncology, critical care, cardiology, nephrology, and infectious disease to address these challenges head-on.

Dr. Sergio Giralt of Memorial Sloan Kettering Cancer Center highlights that while well-known toxicities like cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) remain top concerns, rarer complications — such as CAR-T colitis and late-onset hematotoxicities — are gaining attention. The conference will also spotlight toxicity management in patients aged 75 and older, cardiorenal complications, and the growing role of AI in toxicity prediction and monitoring.

Key Takeaways:

• Multidisciplinary collaboration is essential — hematologists alone can't manage the full spectrum of cellular therapy side effects
• Geriatric assessments and microbiome strategies are emerging as tools to reduce toxicity in older patients
• Deaths linked to immune effector cells in autoimmune disease settings underscore the urgency of better safety protocols
• TIL therapy for solid tumors introduces a new frontier of toxicity considerations distinct from blood cancers

Why it matters: With cellular therapies moving beyond blood cancers into autoimmune diseases and solid tumors, the patient population is broadening — and so are the risks. Building a robust, multidisciplinary framework for toxicity prevention and management is essential to ensuring these powerful treatments can be delivered safely at scale.