# Tocilizumab

Source: https://onco.cc/drugs/tocilizumab/  
OnCo record `tocilizumab` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Tocilizumab (Actemra) is a rheumatoid arthritis antibody that has become the rescue drug for cytokine release syndrome, the fever and blood-pressure crash that CAR-T cells and bispecific antibodies can trigger. Every CAR-T centre must have it on hand.

## Summary

Tocilizumab was approved by the FDA in 2010 for rheumatoid arthritis and in August 2017, on the same day as the first CAR-T approval (tisagenlecleucel), for severe or life-threatening CAR-T-cell-induced cytokine release syndrome in patients aged 2 and over, on a retrospective analysis of pooled CAR-T trials in which about two-thirds of patients had CRS resolve within 14 days of one or two doses. The CAR-T REMS programmes require two doses to be available on site for every patient, and it is used with the same logic for CRS from bispecific T-cell engagers, though not on label. Because it does not cross the blood-brain barrier it does not treat neurotoxicity (ICANS), for which corticosteroids are used. The EU authorised RoActemra in 2009; biosimilars (Tofidence, Tyenne) followed in 2023 to 2024. Serious infection carries a boxed warning in chronic use.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-10
- Also known as: RoActemra; Tofidence; Tyenne
- Tags: nci-list; supportive
- Brand: Actemra
- Modality: Monoclonal antibody (anti-IL-6 receptor, humanised IgG1)
- Mechanism: Binds soluble and membrane-bound IL-6 receptors and blocks IL-6 signalling, the central mediator of cytokine release syndrome after T-cell-redirecting therapy.
- Approvals: US 2010: Rheumatoid arthritis (first approval); US 2017: Severe or life-threatening CAR-T-cell-induced cytokine release syndrome, age 2 and over

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Tocilizumab
- US label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=tocilizumab
- NCI drug page: https://www.cancer.gov/about-cancer/treatment/drugs/tocilizumab

## Connected records

- drugs: [Siltuximab](https://onco.cc/drugs/siltuximab/), [Tisagenlecleucel](https://onco.cc/drugs/tisagenlecleucel/)
- technologies: [CAR-T cell therapy](https://onco.cc/technologies/car-t/), [Infection risk after transplant and cell therapy, phase by phase, and the prophylaxis that follows it](https://onco.cc/technologies/rejuv-tx-infection-by-phase/), [Monoclonal antibodies](https://onco.cc/technologies/monoclonal-antibody/), [T-cell engagers (bispecific)](https://onco.cc/technologies/t-cell-engager/)
- targets: [Interleukin-6 and IL-6 receptor](https://onco.cc/targets/il6/)
- companies: [Roche / Genentech](https://onco.cc/companies/roche-genentech/)
- trials: [A Dose Escalation Study of Glofitamab (RO7082859) as a Single Agent and in Combination With Obinutuzumab, Administered After a Fixed, Single Pre-treat](https://onco.cc/trials/nct03075696/), [A Study Evaluating the Efficacy and Safety of Cevostamab in Prior B Cell Maturation Antigen (BCMA)-Exposed Participants With Relapsed/Refractory Multi](https://onco.cc/trials/nct05535244/), [A Study Evaluating the Efficacy and Safety of Multiple Immunotherapy-Based Treatment Combinations in Patients With Advanced Liver Cancers (Morpheus-Li](https://onco.cc/trials/nct04524871/), [A Study Evaluating the Prophylactic Use of Tocilizumab to Prevent Cytokine Release Syndrome With Ramantamig Administration in Participants With Relaps](https://onco.cc/trials/nct07589634/), [A Study Evaluating the Safety and Efficacy of Multiple Treatments in Participants With Multiple Myeloma](https://onco.cc/trials/nct05583617/), [A Study Evaluating the Safety, Efficacy, and Pharmacokinetics of Mosunetuzumab Monotherapy in Participants With Select B-Cell Malignancies](https://onco.cc/trials/nct05207670/), [A Study Evaluating the Safety, Pharmacokinetics, and Efficacy of Mosunetuzumab + Lenalidomide (+Len), and the Safety, Tolerability, and Pharmacokineti](https://onco.cc/trials/nct04246086/), [A Study to Evaluate Glofitamab as a Single Agent vs. Investigator's Choice in Participants With Relapsed/Refractory Mantle Cell Lymphoma](https://onco.cc/trials/nct06084936/), [A Study to Evaluate the Safety and Efficacy of Glofitamab in Combination With Rituximab (R) Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) in Circulating Tumor (ct)DNA High-Risk Patients With Untreated Diffuse Large B-Cell Lymphoma](https://onco.cc/trials/nct04980222/), [A Study to Evaluate the Safety and Efficacy of Mosunetuzumab (BTCT4465A) in Combination With Polatuzumab Vedotin in B-Cell Non-Hodgkin Lymphoma](https://onco.cc/trials/nct03671018/), [A Study to Evaluate the Safety, Pharmacokinetics and Preliminary Anti-Tumor Activity of Englumafusp Alfa in Combination With Obinutuzumab and in Combi](https://onco.cc/trials/nct04077723/), [An Open-Label Phase lB/II Study of Glofitamab and Atezolizumab or Polatuzumab Vedotin in Adult Patients With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma](https://onco.cc/trials/nct03533283/), [Study of REGN4018 (Ubamatamab) Administered Alone or in Combination With Cemiplimab in Adult Patients With Recurrent Ovarian Cancer or Other Recurrent](https://onco.cc/trials/nct03564340/), [Toci +/- SOC Chemo for Metastatic Triple Negative and ER-positive, HER2-negative Breast Cancers](https://onco.cc/trials/nct05846789/), [Tocilizumab and Atezolizumab in Adults With Locally Advanced or Metastatic Non-Small Cell Lung Cancer Refractory to 1st Line Immune Checkpoint Inhibitor-Based T](https://onco.cc/trials/nct04691817/)
- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/)
- terms: [CD20 bispecific antibodies: step-up dosing, fixed duration and what it is like to take one](https://onco.cc/terms/lymphoma-tx-bispecific-step-up/), [Cytokine release syndrome and ICANS: grading and management](https://onco.cc/terms/lymphoma-tx-crs-icans/)

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