{"entity":{"id":"tocilizumab","kind":"drug","name":"Tocilizumab","aka":["RoActemra","Tofidence","Tyenne"],"tldr":"Tocilizumab (Actemra) is a rheumatoid arthritis antibody that has become the rescue drug for cytokine release syndrome, the fever and blood-pressure crash that CAR-T cells and bispecific antibodies can trigger. Every CAR-T centre must have it on hand.","summary":"Tocilizumab was approved by the FDA in 2010 for rheumatoid arthritis and in August 2017, on the same day as the first CAR-T approval (tisagenlecleucel), for severe or life-threatening CAR-T-cell-induced cytokine release syndrome in patients aged 2 and over, on a retrospective analysis of pooled CAR-T trials in which about two-thirds of patients had CRS resolve within 14 days of one or two doses. The CAR-T REMS programmes require two doses to be available on site for every patient, and it is used with the same logic for CRS from bispecific T-cell engagers, though not on label. Because it does not cross the blood-brain barrier it does not treat neurotoxicity (ICANS), for which corticosteroids are used. The EU authorised RoActemra in 2009; biosimilars (Tofidence, Tyenne) followed in 2023 to 2024. Serious infection carries a boxed warning in chronic use.","status":"approved","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Tocilizumab","links":[{"label":"US label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=tocilizumab"},{"label":"NCI drug page","url":"https://www.cancer.gov/about-cancer/treatment/drugs/tocilizumab"}],"tags":["nci-list","supportive"],"related":["siltuximab","tisagenlecleucel"],"cancers":[],"sections":[],"technologies":["car-t","t-cell-engager","monoclonal-antibody"],"targets":["il6"],"drugs":[],"companies":["roche-genentech"],"institutions":[],"pathways":[],"terms":[],"trials":["nct07589634","nct04077723","nct05583617","nct05535244","nct04246086","nct05207670","nct03075696","nct03671018","nct04524871","nct06084936","nct03533283","nct04980222"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Actemra","modality":"Monoclonal antibody (anti-IL-6 receptor, humanised IgG1)","supportive":true,"mechanism":"Binds soluble and membrane-bound IL-6 receptors and blocks IL-6 signalling, the central mediator of cytokine release syndrome after T-cell-redirecting therapy.","approvals":[{"region":"US","year":2010,"indication":"Rheumatoid arthritis (first approval)"},{"region":"US","year":2017,"indication":"Severe or life-threatening CAR-T-cell-induced cytokine release syndrome, age 2 and over"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/tocilizumab/","neighbours":{"drug":[{"id":"siltuximab","kind":"drug","name":"Siltuximab","route":"/drugs/siltuximab/"},{"id":"tisagenlecleucel","kind":"drug","name":"Tisagenlecleucel","route":"/drugs/tisagenlecleucel/"}],"technology":[{"id":"car-t","kind":"technology","name":"CAR-T cell therapy","route":"/technologies/car-t/"},{"id":"rejuv-tx-infection-by-phase","kind":"technology","name":"Infection risk after transplant and cell therapy, phase by phase, and the prophylaxis that follows it","route":"/technologies/rejuv-tx-infection-by-phase/"},{"id":"monoclonal-antibody","kind":"technology","name":"Monoclonal antibodies","route":"/technologies/monoclonal-antibody/"},{"id":"t-cell-engager","kind":"technology","name":"T-cell engagers (bispecific)","route":"/technologies/t-cell-engager/"}],"target":[{"id":"il6","kind":"target","name":"Interleukin-6 and IL-6 receptor","route":"/targets/il6/"}],"company":[{"id":"roche-genentech","kind":"company","name":"Roche / Genentech","route":"/companies/roche-genentech/"}],"trial":[{"id":"nct03075696","kind":"trial","name":"A Dose Escalation Study of Glofitamab (RO7082859) as a Single Agent and in Combination With Obinutuzumab, Administered After a Fixed, Single Pre-treat","route":"/trials/nct03075696/"},{"id":"nct05535244","kind":"trial","name":"A Study Evaluating the Efficacy and Safety of Cevostamab in Prior B Cell Maturation Antigen (BCMA)-Exposed Participants With Relapsed/Refractory 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Mosunetuzumab + Lenalidomide (+Len), and the Safety, Tolerability, and Pharmacokineti","route":"/trials/nct04246086/"},{"id":"nct06084936","kind":"trial","name":"A Study to Evaluate Glofitamab as a Single Agent vs. Investigator's Choice in Participants With Relapsed/Refractory Mantle Cell Lymphoma","route":"/trials/nct06084936/"},{"id":"nct04980222","kind":"trial","name":"A Study to Evaluate the Safety and Efficacy of Glofitamab in Combination With Rituximab (R) Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) in Circulating Tumor (ct)DNA High-Risk Patients With Untreated Diffuse Large B-Cell Lymphoma","route":"/trials/nct04980222/"},{"id":"nct03671018","kind":"trial","name":"A Study to Evaluate the Safety and Efficacy of Mosunetuzumab (BTCT4465A) in Combination With Polatuzumab Vedotin in B-Cell Non-Hodgkin Lymphoma","route":"/trials/nct03671018/"},{"id":"nct04077723","kind":"trial","name":"A Study to Evaluate the Safety, Pharmacokinetics and Preliminary Anti-Tumor Activity of Englumafusp Alfa in Combination With Obinutuzumab and in Combi","route":"/trials/nct04077723/"},{"id":"nct03533283","kind":"trial","name":"An Open-Label Phase lB/II Study of Glofitamab and Atezolizumab or Polatuzumab Vedotin in Adult Patients With Relapsed/Refractory B-Cell Non-Hodgkin's Lymphoma","route":"/trials/nct03533283/"},{"id":"nct03564340","kind":"trial","name":"Study of REGN4018 (Ubamatamab) Administered Alone or in Combination With Cemiplimab in Adult Patients With Recurrent Ovarian Cancer or Other Recurrent","route":"/trials/nct03564340/"},{"id":"nct05846789","kind":"trial","name":"Toci +/- SOC Chemo for Metastatic Triple Negative and ER-positive, HER2-negative Breast Cancers","route":"/trials/nct05846789/"},{"id":"nct04691817","kind":"trial","name":"Tocilizumab and Atezolizumab in Adults With Locally Advanced or Metastatic Non-Small Cell Lung Cancer Refractory to 1st Line Immune Checkpoint Inhibitor-Based T","route":"/trials/nct04691817/"}],"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"term":[{"id":"lymphoma-tx-bispecific-step-up","kind":"term","name":"CD20 bispecific antibodies: step-up dosing, fixed duration and what it is like to take one","route":"/terms/lymphoma-tx-bispecific-step-up/"},{"id":"lymphoma-tx-crs-icans","kind":"term","name":"Cytokine release syndrome and ICANS: grading and management","route":"/terms/lymphoma-tx-crs-icans/"}]}}