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Endocrine toxicities in Chimeric Antigen Receptor T-Cell Therapy: A pharmacovigilance study from 2017 to 2023 Quarter 1
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  • jizhou liang,
  • Fangyuan Hu,
  • Yinghong Zhai,
  • Chenxin Chen,
  • Xiaojing Guo,
  • Jinfang Xu,
  • Xiaofei Ye,
  • Jia He
jizhou liang
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Fangyuan Hu
Second Military Medical University Department of Health Statistics
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Yinghong Zhai
Tongji University School of Medicine
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Chenxin Chen
Naval Medical University Faculty of Health Service
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Xiaojing Guo
Second Military Medical University Department of Health Statistics
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Jinfang Xu
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Xiaofei Ye
Second Military Medical University Department of Health Statistics
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Jia He
Second Military Medical University

Corresponding Author:[email protected]

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Abstract

Aim: Chimeric antigen receptor (CAR)-T cell therapy represents a revolutionary immunotherapy and cutting-edge strategy for cancer treatment. However, the pharmacological safety of this approach in the endocrine system has yet to be sufficiently validated. This study aims to explore the potential toxicity signals of CAR T-cell therapy in the endocrine system and their clinical relevance. Methods: This study utilized data from the FDA Adverse Event Reporting System (FAERS) database, covering 2017 to the first quarter of 2023 (Q1). Signal detection of adverse events was achieved through the information component method combined with the reporting odds ratio method. Results: A total of 34,216,716 records were available in the FAERS database, and 60,730 records were screened for CAR T-cell therapy as the primary or secondary suspected agent, identifying 12 positive endocrine signals (preferred term), which represent a rare occurrence in the existing literature on CAR T-cell therapy. Hyperglycemia topped the list with 42 reported cases (ROR025=1.01), followed by hypercalcemia (n=26,ROR025=1.45) and adrenal insufficiency (n=15,ROR025=0.66). Exophthalmos-related reports for tisagenlecleucel therapy showed the highest death rate among the positive signals detected (5/6, 83.3%). Adverse event reports related to conditions with fatal outcomes, such as adrenal insufficiency (7/15, 46.7%), and hypercalcemia (13/25, 52.0%), demonstrate significant overlap with cytokine release syndrome (CRS). Conclusions: It is crucial for healthcare professionals to closely monitor the potential adverse events related to the endocrine system that may arise from CAR T-cell therapy. These events necessitate thorough observation after treatment administration and the creation of targeted prevention and treatment strategies