Chimeric antigen receptor T (CAR T) cells have shown their potential in hematological malignancies and the treatment of solid tumors, especially in metastases. However, CAR T-cell therapy may carry risks of inducing severe adverse effects, which are recognized as immune-related adverse events. Here, we report two cases of severe colitis presented with refractory bloody diarrhea, which were induced by carcinoembryonic antigen (CEA)-directed CAR T therapy in the treatment of metastatic colorectal adenocarcinoma. These patients were treated as part of a clinical trial. The clinical trial was registered at ClinicalTrials.gov (NCT05396300), submitted, and started on May 25, 2022. Glucocorticoids combined with vedolizumab were used to control their gastrointestinal symptoms but the outcomes were unsatisfactory. This report highlights the potentially serious risks of anti-CEA CAR T therapy and provides management options.
Keywords: CAR-T-cell therapy; carcinoembryonic antigen; case report; colorectal cancer; immune-related adverse event.
Serious bowel inflammation following novel cancer therapy in colon cancer patients A recent approach for treating cancer, especially in advanced stages where it has spread, uses a type of therapy involving modified immune cells, known as CAR T cell therapy. While it can be very effective, this treatment sometimes causes serious side effects. We discuss two cases where patients experienced severe inflammation of the colon with intense diarrhea after receiving this treatment. They were treated with common medications to reduce inflammation, but unfortunately, these did not work well. Subsequently, a series of complications occurred. Our report highlight the possible risks of this therapy and discuss possible mechanisms.
© The Author(s), 2024.