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From toxicity to immunity: Evaluating CAR-T and conventional therapies in multiple myeloma through quality-adjusted life year (QALY) outcomes.

Multiple myeloma (MM) remains characterized by recurrent relapse and cumulative treatment burden despite major therapeutic advances. This study compared conventional stepwise regimens with CAR-T cell therapy in terms of QoL, toxicity, cost, and ethical considerations within a model-based comparative framework. This comparative pharmacoeconomic modeling analysis was based on published clinical trial data. Kaplan-Meier survival curves were digitized to estimate mean overall survival (OS) and progression-free survival (PFS) using area-under-the-curve integration. Treatment costs were calculated b

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… In contrast, daratumumab is generally well tolerated, with only mild infusion-related reactions such as fever, chills, or nasal congestion. 26 The incorporation of anti-CD38 antibodies enhances treatment depth without increasing toxicity, markedly improving MRD negativity rates and extending PFS (see …

Mitigation and Management of Common Toxicities Associated with the Administration of CAR-T Therapies in Oncology Patients.

Chimeric antigen receptor T-cell (CAR-T) therapies are one of the main approaches among targeted cellular therapies. Despite the potential benefit and durable responses observed in some patients receiving CAR-T therapies, serious and potentially fatal toxicities remain a major challenge. The most common CAR-T-associated toxicities include cytokine release syndrome (CRS), neurotoxicity, cytopenias, and infections. While CRS and neurotoxicity are generally managed with tocilizumab and corticosteroids, respectively, high-grade toxicities can be life-threatening. Close postinfusion monitoring and

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… The severity of CRS ranges from mild, flu-like symptoms, including fever and chills, to severe and life-threatening symptoms, including hypotension, tachycardia, pleural effusion, pulmonary edema, capillary leak syndrome, and hypoxia, which may ultimately lead to multisystem organ failure and death [ …

Histone deacetylase inhibitors for leukemia treatment: current status and future directions.

Leukemia remains a major therapeutic challenge in clinical oncology. Despite significant advancements in treatment modalities, leukemia remains a significant cause of morbidity and mortality worldwide, as the current conventional therapies are accompanied by life-limiting adverse effects and a high risk of disease relapse. Histone deacetylase inhibitors have emerged as a promising group of antineoplastic agents due to their ability to modulate gene expression epigenetically. In this review, we explore these agents, their mechanisms of action, pharmacokinetics, safety and clinical efficacy, mon

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… Grade III fatigue, N/V, and chills were the observed dose-limiting toxicities Chiappella et al. (2023) [ 167 ] | Italy | Phase Ib/II | Romidepsin (FK228) | Chemotherapy (CHOEP), SCT | PTCL | No unexpected toxicities were recorded, with an ORR of 71% and CR of 62%. …

Efficacy and Safety of Tixagevimab/Cilgavimab to Prevent COVID-19 (Pre-Exposure Prophylaxis): A Systematic Review and Meta-Analysis.

Background: Tixagevimab/cilgavimab (TGM/CGM) are neutralizing monoclonal antibodies (mAbs) directed against different epitopes of the receptor-binding domain of the SARS-CoV-2 spike protein that have been considered as pre-exposure prophylaxis (PrEP). Objectives: This study seeks to assess the efficacy and safety of TGM/CGM to prevent COVID-19 in patients at high risk for breakthrough and severe SARS-CoV-2 infection who never benefited maximally from SARS-CoV-2 vaccination and for those who have a contraindication to SARS-CoV-2 vaccines. Design: This study is a systematic review and meta-analy

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… 52–54) | 2 (66.7) | LTRs | 77 LTRs received: TGM/CGM (IM) (150–150 mg dose) | No comparator group | 1, 0, and 29 | Not reported | In the TGM/CGM group, patients had myalgia ( n = 3), arthralgia ( n = 2), fatigue ( n = 2), nausea and vomiting ( n = 1), diarrhea ( n = 1), intermittent fevers ( n = 1), chills …

Immunotherapy for Hepatocellular Carcinoma: Current Status and Future Prospects.

Hepatocellular carcinoma (HCC) is the most prevalent primary liver cancer with poor prognosis. Surgery, chemotherapy, and radiofrequency ablation are three conventional therapeutic options that will help only a limited percentage of HCC patients. Cancer immunotherapy has achieved dramatic advances in recent years and provides new opportunities to treat HCC. However, HCC has various etiologies and can evade the immune system through multiple mechanisms. With the rapid development of genetic engineering and synthetic biology, a variety of novel immunotherapies have been employed to treat advance

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… Although side effects such as pyrexia, chills, myalgia, and fatigue were associated with CIK therapy in 17% of patients, they were not severe enough to discontinue therapy ( 56 ). …

Targeting B Cell Maturation Antigen (BCMA) in Multiple Myeloma: Potential Uses of BCMA-Based Immunotherapy.

The approval of the first two monoclonal antibodies targeting CD38 (daratumumab) and SLAMF7 (elotuzumab) in late 2015 for treating relapsed and refractory multiple myeloma (RRMM) was a critical advance for immunotherapies for multiple myeloma (MM). Importantly, the outcome of patients continues to improve with the incorporation of this new class of agents with current MM therapies. However, both antigens are also expressed on other normal tissues including hematopoietic lineages and immune effector cells, which may limit their long-term clinical use. B cell maturation antigen (BCMA), a transme

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… PIs, IMiDs, ±stem cell transplantation) | IV infusion for 1 h ever 3 weeks 8 dose levels 0.03, 0.06, 0.12, 0.24, 0.48, 0.96, 1.92, 3.4 mg/kg | 1 MR at 0.24 mg/kg 1 VGPR, 3 PR, and 1 MR at doses ≥0.96 mg/kg Clinical benefit rate: 25% | Overall: 23/24 (96%), nausea (42%), fatigue (38%), anemia (29%), chills …

AllergoOncology - the impact of allergy in oncology: EAACI position paper.

Th2 immunity and allergic immune surveillance play critical roles in host responses to pathogens, parasites and allergens. Numerous studies have reported significant links between Th2 responses and cancer, including insights into the functions of IgE antibodies and associated effector cells in both antitumour immune surveillance and therapy. The interdisciplinary field of AllergoOncology was given Task Force status by the European Academy of Allergy and Clinical Immunology in 2014. Affiliated expert groups focus on the interface between allergic responses and cancer, applied to immune surveill

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… Other systemic symptoms such as chills and fever are thought to be due to the release of IL‐1 and IL‐6 among others 125 . Atypical symptoms such as pain have been associated with taxanes and some monoclonal antibodies 126 . …

Race for the Cure: From the Oldest to the Newest Monoclonal Antibodies for Multiple Myeloma Treatment.

Multiple myeloma is characterized by a wide clinical heterogeneity due to an intricate network of interactions between bone marrow-resident clonal plasma cells and the microenvironment. Over the last years, dramatic improvement in the understanding of these pathways led to the introduction of novel drugs with immune-mediated mechanisms of action. Some of these compounds, such as the anti-cd38 daratumumab and isatuximab, the anti-slamf-7 elotuzumab, and the antibody-drug conjugate belantamab-mafodotin, have been tested in large clinical trials and have now fully entered the real-life management

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… Another frequently reported side effect is represented by infusion-related reactions, mainly occurring at the first infusion and usually presenting with mild-to-moderate symptoms such as nasal congestion, cough, throat irritation, chills, vomiting, and nausea. …

The Black Hole: CAR T Cell Therapy in AML.

Despite exhaustive studies, researchers have made little progress in the field of adoptive cellular therapies for relapsed/refractory acute myeloid leukemia (AML), unlike the notable uptake for B cell malignancies. Various single antigen-targeting chimeric antigen receptor (CAR) T cell Phase I trials have been established worldwide and have recruited approximately 100 patients. The high heterogeneity at the genetic and molecular levels within and between AML patients resembles a black hole: a great gravitational field that sucks in everything. One must consider the fact that only around 30% of

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… injury, grade 2 mucositis, grade 1 tachycardia for 1 patient; and a second patient experienced grade 2 intermittent orthostatic hypotension, grade 2 increased bilirubin and grade 3 increased ALT and AST | [ 9 ] Case report | CD33 | CD33-4-1BB/1.12 × 10 9 | 1 | Disease progression at week 9 | Grade 4 chills …

Antibody-Drug Conjugates for Multiple Myeloma: Just the Beginning, or the Beginning of the End?

Multiple myeloma is a malignancy of immunoglobulin-secreting plasma cells that is now often treated in the newly diagnosed and relapsed and/or refractory settings with monoclonal antibodies targeting lineage-specific markers used either alone or in rationally designed combination regimens. Among these are the anti-CD38 antibodies daratumumab and isatuximab, and the anti-Signaling lymphocytic activation molecule family member 7 antibody elotuzumab, all of which are used in their unconjugated formats. Single-chain variable fragments from antibodies also form a key element of the chimeric antigen

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… Treatment emergent adverse events (TEAEs) occurring in ≥20% of patients included chills, fatigue, nausea, anemia, headache, pyrexia, infusion reaction, decreased appetite, and abdominal pain. …

Serious adverse events and coping strategies of CAR-T cells in the treatment of malignant tumors.

Chimeric antigen receptor T (CAR-T) cells technology has been successfully used in the treatment of B cell-derived hematological tumors and multiple myeloma. CAR-T cells are also being studied in a variety of solid tumors. Current clinical reports on CAR-T cells in the treatment of malignant tumors are abundant. The tumor-killing activity of CAR-T cells and the unique adverse effects of CAR-T cells have been confirmed by many studies. There is evidence that serious adverse events can be life-threatening. CAR-T cells therapy is increasingly used in clinical settings, so it is important to pay a

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… CRS | | | 1/Abdominal pain | 3/Hypotension;1/Embolism NCT02030847 (30) | | 3/Sepsis;2/Pneumonia;1/Meningitis;1/Staphylococcal infection | | 1/Haemorrhage intracranial; 1/Headache;1/Seizure | 21/CRS | 1/Febrile neutropenia | 1/Hypoxia | 1/Constipation | NCT02614066 (125) | 20/Pyrexia;2:Fatigue; 1:Chills …

Oncolytic Adenovirus: Prospects for Cancer Immunotherapy.

Immunotherapy has moved to the forefront of modern oncologic treatment in the past few decades. Various forms of immunotherapy currently are emerging, including oncolytic viruses. In this therapy, viruses are engineered to selectively propagate in tumor cells and reduce toxicity for non-neoplastic tissues. Adenovirus is one of the most frequently employed oncolytic viruses because of its capacity in tumor cell lysis and immune response stimulation. Upregulation of immunostimulatory signals induced by oncolytic adenoviruses (OAds) might significantly remove local immune suppression and amplify

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… There were no DLTs, and the most common AEs were chills and fever associated with Ad replication. Disappointingly, one patient was diagnosed with infectious colitis related to ONCOS-102. …

Approaches and Challenges in the Management of Multiple Myeloma in the Very Old: Future Treatment Prospects.

The increasing incidence of geriatric patients with multiple myeloma has elevated concerns in clinical practice. While the introduction of novel therapeutic agents has substantially improved outcomes in younger patients with myeloma, poorer outcomes remain in older patients. Managing older patients requires a multidisciplinary team approach to consider factors that may influence both treatment selection and outcomes. Aging is associated with remodeling of vital organs, physiological downregulations of basal metabolism, susceptibility to multiple comorbidities with ultimate frailty, thereby con

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… AEs reported were infusion-related such as cough, headache, back pain, fever and chills. Generally, elotuzumab was well-tolerated without dose-limiting toxicity, justifying a further investigation of combinational therapy rather than as monotherapy ( 119 ). …

A year in pharmacology: new drugs approved by the US food and drug administration in 2025.

The US Food and Drug Administration approved 45 new drugs and 4 new cellular and gene therapy products in 2025, that is, a total of 49 new medical therapies. Oncology, hematology/immunotherapy, and cardiovascular/respiratory drugs remain most frequent. Among oncology drugs, there is a trend for targeting ever smaller subtypes of malignancies and/or rarer malignancies. Trends over the past 6 years include steady levels of first-in-indication (about 10%), first-in-class (about 38%), and next-in-class (about 51%) approvals. Along with a large share of approvals in orphan indications (> 50%), fast

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… Fifty-one percent of the treated patients achieved a complete response, and AEs were generally mild, most commonly comprising injection-site reactions, fatigue, chills, and fever (Norberg et al. 2025 ). Thrombotic events have also been reported. …

The role and novel use of natural killer cells in graft-versus-leukemia reactions after allogeneic transplantation.

Allogeneic hematopoietic cell transplantation (HCT) has transformed over the past several decades through enhanced supportive care, reduced intensity conditioning (RIC), improved human leukocyte antigen (HLA) typing, and novel graft-versus-host disease (GVHD)-prevention and treatment strategies. Most notably, the implementation of post-transplantation cyclophosphamide (PTCy) has dramatically increased the safety and availability of this life-saving therapy. Given reductions in nonrelapse mortality (NRM) with these advances, the HCT community has placed even greater emphasis on developing ways

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… toxin; DFS, disease-free survival; CML, chronic myeloid leukemia; mbIL21, membrane-bound interleukin 21; NRM, non-relapse mortality; NMA, nonmyeloablative; ALT, alanine aminotransferase; AST, aspartate transaminase; PTCy, post-transplantation cyclophosphamide; CAR, chimeric antigen receptor *fever, chills …

Toxicity Profile of Chimeric Antigen Receptor T-Cell and Bispecific Antibody Therapies in Multiple Myeloma: Pathogenesis, Prevention and Management.

Multiple myeloma is the second-most common hematologic malignancy in adults worldwide. Despite ongoing advancement in therapeutic modalities, it remains an incurable disease with a 5-year survival rate of approximately 50%. The recent development and introduction of anti-BCMA immunotherapies into clinical practice, including chimeric antigen receptor T-cell (CAR-T) therapies and bispecific antibodies, has radically shifted the treatment paradigm. However, despite the promising potential of these therapies for broader application, frequent and significant adverse effects have been reported, bot

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… Presentation CRS is characterized by a constellation of symptoms, most commonly fever, chills/rigors, fatigue, and anorexia. These symptoms can persist for several days, and progress to severe CRS, with hypotension, hypoxia, and organ dysfunction [ 19 ]. …

A year in pharmacology: new drugs approved by the US Food and Drug Administration in 2021.

The second year of the COVID-19 pandemic had no adverse effect on the number of new drug approvals by the US Food and Drug Administration (FDA). Quite the contrary, with a total of 50 new drugs, 2021 belongs to the most successful FDA years. We assign these new drugs to one of three levels of innovation: (1) first drug against a condition ("first-in-indication"), (2) first drug using a novel molecular mechanism ("first-in-class"), and (3) "next-in-class", i.e., a drug using an already exploited molecular mechanism. We identify 21 first-in-class, 28 next-in-class, and only one first-in-indicati

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… Serious reactions included hypersensitivity reactions like anaphylaxis and infusion-associated reactions, including respiratory distress, chills, and raised body temperature (pyrexia). …

Molecular Mechanism and Prevention Strategy of Chemotherapy- and Radiotherapy-Induced Ovarian Damage.

Fertility preservation is an emerging discipline, which is of substantial clinical value in the care of young patients with cancer. Chemotherapy and radiation may induce ovarian damage in prepubertal girls and young women. Although many studies have explored the mechanisms implicated in ovarian toxicity during cancer treatment, its molecular pathophysiology is not fully understood. Chemotherapy may accelerate follicular apoptosis and follicle reservoir utilization and damage the ovarian stroma via multiple molecular reactions. Oxidative stress and the radiosensitivity of oocytes are the main c

Бремя лечения, секвенирования и использования ресурсов здравоохранения в множестве миеломы в Латинской Америке: обзор целевой литературы.

Утверждение основных классов лекарственных препаратов позволило улучшить выживание пациентов с множественной миеломой (ММ). В то же время большинство пациентов сталкиваются с рецидивом или становятся противниками этих методов лечения, причем повторное лечение имеет ограниченную эффективность. Доступ к этим основным методам лечения в разных странах Латинской Америки (ЛАТАМ), что может привести к неоптимальным клиническим результатам. Цель этого целевого обзора литературы заключалась в том, чтобы понять эпидемиологию, бремя лечения, последовательность лечения и наличие MM в Аргентине, Бразилии,

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… Infusion-related reactions were reported in 34–51.0% of patients treated with daratumumab, including dyspnea, cough, pyrexia, throat irritation and chills, which mostly occurred during the first infusion and were generally grade 1 or 2 in severity [ 48 , 54 ]. …

Mechanisms and Functions of γδ T Cells in Tumor Cell Recognition.

γδ T cells are among the first line of defense in the immune system, playing a crucial role in bridging innate and adaptive immunity. Although γδ T cells are crucial for tumor immune surveillance, the complete mechanism by which γδ T cell receptors identify molecular targets in target cells remains unknown. Target cells can produce phosphoantigens (PAgs) via the mevalonate pathway or the methylerythritol phosphate pathway. The BTN3A1-BTN2A1 complex undergoes conformational changes in its extracellular domains upon binding to PAgs, leading to Vγ9Vδ2 T cell recognition. However, the structural b

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… Second, CAR-γδ T-cell therapy has been associated with potential side effects such as fever, chills, and headaches. Therefore, thoroughly assessing the condition and physical status of the patient when administering CAR-γδ T-cell therapy is imperative. …