Table 1 Comparison of cytokine storm and CRS

Pathogenesis

Immune system is activated independent of tumor targeting, as with antibodies specific for CD3 or CD28

T cells become activated as they recognize tumor antigen

Timing

T cell activation and clinical symptoms occur within minutes to hours of treatment

Symptoms may be delayed until days or weeks after treatment, depending on the kinetics of T cell activation

Mediators

TNFα and IFNγ are key mediators

IL-6 is a key mediator

Treatment

Symptoms can be resolved using corticosteroids or by stopping the T cell-directed infusion

Symptoms can be resolved using IL-6 pathway inhibition or corticosteroids