Sylvant (siltuximab)

P2, N=30, Active, not recruiting, Memorial Sloan Kettering Cancer Center | Trial completion date: Oct 2025 --> Oct 2026 | Trial primary completion date: Oct 2025 --> Oct 2026

P2, N=40, Recruiting, Massachusetts General Hospital | Trial primary completion date: Mar 2026 --> Nov 2026

P2, N=14, Recruiting, University of Pennsylvania | Not yet recruiting --> Recruiting

P2, N=30, Active, not recruiting, University of Alabama at Birmingham | Recruiting --> Active, not recruiting

Key drivers of iMCD pathogenesis, such as interleukin-6 dysregulation and other dysfunctional cytokine signaling, have been identified and led to the development of targeted therapies like siltuximab and tocilizumab. Emerging technologies, including single-cell sequencing, spatial transcriptomics, and digital pathology, offer promise in refining diagnostic precision and advancing personalized medicine. This review synthesizes historical frameworks, recent breakthroughs, and future directions in iMCD diagnostics, emphasizing the importance of multidisciplinary approaches for improved patient outcomes.

P1, N=6, Terminated, H. Lee Moffitt Cancer Center and Research Institute | Trial completion date: Nov 2027 --> Oct 2024 | Active, not recruiting --> Terminated | Trial primary completion date: Nov 2026 --> Oct 2024; lack of efficacy/futility

P2, N=7, Active, not recruiting, University of Pennsylvania | Trial completion date: Jun 2025 --> Jun 2026

P2, N=20, Recruiting, Institute of Hematology & Blood Diseases Hospital, China

CSF IL-6 was the most frequently elevated cytokine in our cohort, observed across a range of primary and secondary neuroinflammatory disorders. While not diagnostic of a specific condition, its elevation may help guide treatment decisions.

P2, N=14, Not yet recruiting, University of Pennsylvania

Broadly speaking, treatments for Castleman disease can be considered in three categories: immunomodulators such as corticosteroids, cytokine inhibitors and sirolimus; anti-lymphoma therapies such as rituximab, cytotoxic chemotherapy and bruton's tyrosine kinase inhibitors, and anti-myeloma therapies such as thalidomide and bortezomib. The first-line therapy for all subtypes of iMCD is siltuximab, an IL-6 antagonist. Patients with refractory disease have numerous treatment options and consulting treatment guidelines as well as consultation with a center with expertise in Castleman disease are recommended.

P1, N=30, Not yet recruiting, Washington University School of Medicine