Tocilizumab
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.
Overview
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.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2010 | Rheumatoid arthritis (first approval) |
| US | 2017 | Severe or life-threatening CAR-T-cell-induced cytokine release syndrome, age 2 and over |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Tocilizumab" OR ABSTRACT:"Tocilizumab" OR TITLE:"Actemra" OR ABSTRACT:"Actemra" OR TITLE:"RoActemra" OR ABSTRACT:"RoActemra" OR TITLE:"Tofidence" OR ABSTRACT:"Tofidence" OR TITLE:"Tyenne" OR ABSTRACT:"Tyenne") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Tocilizumab, not a curated reading list.
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