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. 2023 Nov;15(16):1363-1368.
doi: 10.2217/imt-2023-0093. Epub 2023 Sep 4.

Tumor lysis syndrome induced by tebentafusp

Theresa Ruf  1 , Anna Leonhardt  1 , David Anz  2 , Wolfgang G Kunz  3 , Natascha Röhrle  2 , Paul Foerster  4 , Dirk Tomsitz  1 , Lars Einar French  1   5 , Marlene Seegräber  1 , Lucie Heinzerling  1
Affiliations

Tumor lysis syndrome induced by tebentafusp

Theresa Ruf et al. Immunotherapy. 2023 Nov.

Abstract

Tebentafusp, a bispecific T-cell receptor fusion protein directed against gp100 and CD3, can improve survival in patients with metastatic uveal melanoma and was recently approved for the treatment of HLA-A*02:01-positive uveal melanoma patients. Since tebentafusp often induces cytokine-release syndrome, doses must be escalated and patients monitored as inpatients after the first infusions. The occurrence of tumor lysis syndrome, a potentially life-threatening condition, after administration of a single dose of tebentafusp, is reported here. With adequate therapy, including the application of rasburicase, the patient made a full recovery. It is important to raise awareness of the adverse event profile of this new therapeutic approach among healthcare professionals to promptly recognize and treat side effects.

Keywords: adverse events; immunotherapy; tebentafusp; tumor lysis syndrome; uveal melanoma.

Plain language summary

Tebentafusp is a new treatment for a type of eye cancer called uveal melanoma. It helps the body's defense system fight against cancer cells and has shown promise in helping patients live longer. However, not all patients with uveal melanoma can use this treatment. Only those who have a specific gene marker called HLA-A*02:01-positive can benefit from it. Like any new treatment, tebentafusp may have some side effects. One of them is called cytokine-release syndrome, which can cause symptoms like rash, fever and flu-like feelings. Usually, this side effect is not serious and can be treated well. There was a rare but serious case where one patient had a bad reaction after getting only one dose of tebentafusp. This reaction is called tumor lysis syndrome, which happens when cancer cells break down quickly and release harmful substances into the blood. This can be life-threatening. Thankfully, the patient received the right treatment and got better. This information is shared here with doctors and patients, so they know about possible side effects and can use tebentafusp safely.

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