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Table 3 NCI recommendation for the use of tocilizumab in patients with CAR T-cell-associated CRS (according to [9])

From: New drugs, new toxicities: severe side effects of modern targeted and immunotherapy of cancer and their management

Tocilizumab 4 to 8 mg/kg i.v. (1-h infusion, maximum 800 mg)  
(1) Decrease of LVEF <40% assessed by echocardiogram  
(2) Increase of creatinine >2.5-fold compared to baseline  
(3) Norepinephrine support (>2 μg/min) for 48 h since start of vasopressors (even if non-continuous administration)  
(4) Decrease of systolic blood pressure <90 mmHG despite vasopressor support  
(5) Severe dyspnea potentially requiring mechanical ventilation  
(6) APTT >2× UNL  
(7) Persisting elevation (>5× UNL) of creatinine kinase longer than 48 h  
  1. CRS cytokine release syndrome, CAR chimeric antigen receptor, i.v. intravenously, LVEF left ventricular ejection fraction, UNL upper normal limit, APTT activated partial thromboplastin time