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Opinion|Videos|May 29, 2025

CRS Recognition and Intervention: Timing and Clinical Features

Author(s)Samuel Rosner, MD, Ranee Mehra, MD, Michelle Sittig, RN, OCN

Panelists discuss how recognizing and grading cytokine release syndrome (CRS) based on symptoms ranging from mild flulike effects to life-threatening conditions is essential for timely intervention, with early detection being key to managing CRS effectively and preventing progression to severe stages.

Episodes in this series

EP. 1 ES-SCLC vs LS-SCLC: Critical Differences in Disease Burden and Patient Prognosis

EP. 1 ES-SCLC vs LS-SCLC: Critical Differences in Disease Burden and Patient Prognosis

EP. 2 Current Treatment Paradigm: Evolution of First-Line Therapy for ES-SCLC

EP. 2 Current Treatment Paradigm: Evolution of First-Line Therapy for ES-SCLC

EP. 3 Addressing Critical Unmet Needs in ES-SCLC Patient Management

EP. 3 Addressing Critical Unmet Needs in ES-SCLC Patient Management

EP. 4 Emerging Clinical Trials: Novel Approaches in Second-Line ES-SCLC

EP. 4 Emerging Clinical Trials: Novel Approaches in Second-Line ES-SCLC

EP. 5 Institutional Implementation: Setting Up Tarlatamab Administration

EP. 5 Institutional Implementation: Setting Up Tarlatamab Administration

EP. 6 Optimizing Multidisciplinary Coordination for Successful Tarlatamab Implementation

EP. 6 Optimizing Multidisciplinary Coordination for Successful Tarlatamab Implementation

EP. 7 Patient Selection Criteria: Identifying Appropriate Candidates for Tarlatamab

EP. 7 Patient Selection Criteria: Identifying Appropriate Candidates for Tarlatamab

EP. 8 Tarlatamab Administration and Postinfusion Monitoring

EP. 8 Tarlatamab Administration and Postinfusion Monitoring

EP. 9 Essential Patient and Caregiver Education for Tarlatamab Treatment Success

EP. 9 Essential Patient and Caregiver Education for Tarlatamab Treatment Success

EP. 10 Neurological Toxicity Recognition: ICANS Assessment and Management

EP. 10 Neurological Toxicity Recognition: ICANS Assessment and Management

EP. 11 CRS Recognition and Intervention: Timing and Clinical Features

EP. 11 CRS Recognition and Intervention: Timing and Clinical Features

EP. 12 Nonimmune Adverse Effects: Managing Dysgeusia and Fatigue

EP. 12 Nonimmune Adverse Effects: Managing Dysgeusia and Fatigue

EP. 13 Differential Toxicity Profile: Tarlatamab vs Traditional Cytotoxic Therapies

EP. 14 Standardized Toxicity Grading: Institutional Protocols for CRS and ICANS

EP. 14 Standardized Toxicity Grading: Institutional Protocols for CRS and ICANS

EP. 15 Future Research Priorities: Optimizing Tarlatamab Administration and Toxicity Management

EP. 15 Future Research Priorities: Optimizing Tarlatamab Administration and Toxicity Management

EP. 16 Seamless Transitions: Managing the Inpatient to Outpatient Care Continuum

EP. 16 Seamless Transitions: Managing the Inpatient to Outpatient Care Continuum

EP. 17 Complex ES-SCLC Case: Tarlatamab Management Through Toxicity to Clinical Benefit

EP. 17 Complex ES-SCLC Case: Tarlatamab Management Through Toxicity to Clinical Benefit

Summary for Physicians:

Cytokine Release Syndrome (CRS) Recognition and Intervention

CRS recognition:
Commonly occurs within 24 to 48 hours post infusion.

Symptoms include fever, chills, tachycardia, hypotension, dyspnea, and rash.
Grading CRS:
Grade 1: Mild fever and flulike symptoms, manageable with supportive care

Grade 2: Moderate symptoms (eg, hypotension), requires medical intervention (eg, fluids, antipyretics)

Grade 3: Severe symptoms (eg, hypoxia, multiorgan involvement), requires steroids and possibly tocilizumab

Grade 4: Life-threatening, requires emergency management and intensive care unit care
Intervention:
Grade 1: Symptom management (eg, acetaminophen, hydration)

Grade 2: Intravenous fluids, antipyretics, monitoring

Grade 3/4: Corticosteroids, tocilizumab (IL-6 inhibitor), and intensive monitoring

Challenges:

Early recognition is crucial for effective management and preventing progression to severe CRS.

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Show Me the Data®: New and Emerging Roles for Oral SERD Therapy in the Treatment of ER+/HER2– Breast Cancer

Show Me the Data®: New and Emerging Roles for Oral SERD Therapy in the Treatment of ER+/HER2– Breast Cancer

Ana C. Garrido-Castro, MD; Pedram Razavi, MD, PhD

Expert Roundtable and Panel Discussions: Current and Future Landscape of TNBC

Expert Roundtable and Panel Discussions: Current and Future Landscape of TNBC

Aditya Bardia, MD, MPH, FASCO; Erika P. Hamilton, MD; Tiffany A. Traina, MD, FASCO

Advances in Managing EGFR-Mutant NSCLC: Applying Evidence Across the Disease Continuum

Advances in Managing EGFR-Mutant NSCLC: Applying Evidence Across the Disease Continuum

Tina Cascone, MD, PhD; Christina Baik, MD, MPH; David Planchard, MD, PhD

Enhancing Prostate Cancer Outcomes – The Role of PSMA and Targeted Treatment Strategies

Enhancing Prostate Cancer Outcomes – The Role of PSMA and Targeted Treatment Strategies

Ana Kiess, MD, PhD; Erin Grady, MD, CCD, FACNM, FSNMMI; Himanshu Nagar, MD, MS; Scott T. Tagawa, MD, MS, FASCO, FACP

Establishing the Rationale for ADC and ICI Combinations in TNBC

Establishing the Rationale for ADC and ICI Combinations in TNBC

Virginia Kaklamani, MD, DSc; Tiffany A. Traina, MD, FASCO

Breaking Down the Latest Clinical Data for First-line Maintenance and R/R SCLC

Breaking Down the Latest Clinical Data for First-line Maintenance and R/R SCLC

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Hossein Borghaei, DO, MS

PER Resource Center: Integrating Novel Approaches in TNBC – New Avenues for TROP2-Targeting ADCs and Beyond – Nursing

PER Resource Center: Integrating Novel Approaches in TNBC – New Avenues for TROP2-Targeting ADCs and Beyond – Nursing

Aditya Bardia, MD, MPH, FASCO; Erika P. Hamilton, MD; Virginia Kaklamani, MD, DSc; Filipa Lynce, MD; Rita Nanda, MD; Tiffany A. Traina, MD, FASCO

Navigating Treatment Gaps in SCLC: Relapse, Resistance, and Need for New Options

Navigating Treatment Gaps in SCLC: Relapse, Resistance, and Need for New Options

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Giannis Mountzios ΜD, PhD

Medical Crossfire® in Adjunctive Testing: Charting a New Course in Prostate Cancer Risk Assessment

Medical Crossfire® in Adjunctive Testing: Charting a New Course in Prostate Cancer Risk Assessment

Jason Hafron, MD; Aaron D. Berger, MD; Arpeet Shah, MD

Radioligand Therapy 101: The Science Behind the Strategy

Radioligand Therapy 101: The Science Behind the Strategy

Jeremie Calais, MD, PhD; Tanya B. Dorff, MD; Scott T. Tagawa, MD, MS, FACP, FASCO

Navigating Advances in Neovascular Retinal Disease: Translating Evidence to Practice in AMD, DME, and RVO

Navigating Advances in Neovascular Retinal Disease: Translating Evidence to Practice in AMD, DME, and RVO

SriniVas R. Sadda, MD, FARVO; Mark R. Barakat, MD, FASRS; David A. Eichenbaum, MD, FASRS

Navigating the Adverse Event Landscape in HER2+ GEA Therapy

Navigating the Adverse Event Landscape in HER2+ GEA Therapy

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Geoffery Ku, MD; Shruti Patel, MD

21st Annual New York Lung Cancers Symposium®

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21st Annual New York Lung Cancers Symposium®

November 14, 2026

The Rise of Novel HER2-Targeting Therapies in GEA: Mechanisms and Clinical Data

The Rise of Novel HER2-Targeting Therapies in GEA: Mechanisms and Clinical Data

Rahul Gosain, MD, MBA; Rohit Gosain, MD

Revolutionizing TGCT Care with Multidisciplinary Perspectives and Cutting-Edge Targeted Therapies

Revolutionizing TGCT Care with Multidisciplinary Perspectives and Cutting-Edge Targeted Therapies

Mark Agulnik, MD; Lee M. Zuckerman, MD

SimulatEd™: A Roadmap to Personalized Care Plans and Shared Decision-Making in Low-Grade Serous Ovarian Cancer

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SimulatEd™: A Roadmap to Personalized Care Plans and Shared Decision-Making in Low-Grade Serous Ovarian Cancer

Rachel N. Grisham, MD

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