ORIHI’s publication of the month highlights outstanding work by Osler researchers, showcasing key insights, impact and contributions that advance research and align with our organizational priorities. September 2026 celebrates Shalini Fernandes, Diya Nijjar, Lollita Rahaman, Shannon Farley and Sabiha Delawala’s publication.
A real-world analysis of adverse events and operational impacts of using T-cell engager therapy in an oncology setting
Canadian Oncology Nursing Journal (2026)
Summary
T-cell engager (TCE) therapies harness the patient’s immune system to induce targeted anti-tumour activity, promoting cancer cell destruction while minimizing damage to surrounding healthy tissues. Despite their therapeutic potential, TCEs are associated with significant toxicities during initial treatment doses, most notably cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). At the time of TCE implementation, limited clinical guidance and operational protocols were available, highlighting the need to systematically evaluate our early real-world experience to inform safe and effective practice.
Highlights
- CRS events were concentrated within the first 24 hours following treatment, with 47% occurring within the first 12 hours
- All grade 1 CRS events without early tocilizumab intervention progressed to grade 2 severity
- ICANS occurred in 27% of patients, highlighting the need for specialized neurological monitoring and management protocols
- The geographic distribution of patients identified important logistical considerations for treatment planning and care delivery
Impact
The findings enabled the team to inform evidence-based recommendations for refining CRS and ICANS management protocols, including optimizing patient admission durations, improving hospital resource utilization, enhancing patient experience and ultimately improving clinical outcomes.
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