FDA Modifies CAR T Cell REMS

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FDA says it has determined that the Risk Evaluation and Mitigation Strategies (REMS) for autologous chimeric antigen receptor (CAR) T cell immunotherapies must be modified to minimize the burden on the healthcare delivery system. An online post says currently, the risks for CAR T cell immunotherapies can be conveyed adequately through the current product labeling, which includes a Boxed Warning for the risks of cytokine release syndrome (CRS) and neurological toxicities, and the Medication Guides that are a part of the approved labeling.

“REMS have been modified to remove requirements for educational and training materials,” the notice says. “Additionally, the requirement to report adverse events suggestive of CRS or neurological toxicities to the REMS has been removed. Adverse event reporting requirements in accordance with [regulations] are adequate for continued routine safety monitoring for these products.”

FDA says the goal of the modified REMS is to mitigate the risks of CRS and neurological toxicities by ensuring that hospitals and their associated clinics that dispense the six listed products are specially certified and have on-site, immediate access to tocilizumab, used to treat CAR T-related CRS.

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