CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging Neurotoxicities
The advent of chimeric antigen receptor (CAR)-T cells has recently changed the prognosis of relapsing/refractory diffuse large B-cell lymphomas, showing response rates as high as 60 to 80%. Common toxicities reported in the pivotal clinical trials include the cytokine release syndrome (CRS) and the...
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MDPI AG
2024-11-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/14/12/1220 |
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| author | Leonardo Palazzo Valentina Pieri Giulia Berzero Massimo Filippi |
| author_facet | Leonardo Palazzo Valentina Pieri Giulia Berzero Massimo Filippi |
| author_sort | Leonardo Palazzo |
| collection | DOAJ |
| description | The advent of chimeric antigen receptor (CAR)-T cells has recently changed the prognosis of relapsing/refractory diffuse large B-cell lymphomas, showing response rates as high as 60 to 80%. Common toxicities reported in the pivotal clinical trials include the cytokine release syndrome (CRS) and the Immune effector Cell-Associated Neurotoxicity Syndrome (ICANS), a stereotyped encephalopathy related to myeloid cell activation and blood–brain barrier dysfunction, presenting with a distinctive cascade of dysgraphia, aphasia, disorientation, attention deficits, vigilance impairment, motor symptoms, seizures, and diffuse brain oedema. The tremendous oncological efficacy of CAR-T cells observed in systemic B-cell malignancies is leading to their growing use in patients with primary or secondary central nervous system (CNS) lymphomas and in patients with solid tumours, including several CNS cancers. Early studies conducted in adult and paediatric patients with solid CNS tumours reported a distinct profile of neurotoxicity referred to as Tumour inflammation-associated neurotoxicity (TIAN), corresponding to local inflammation at the tumour site manifesting with focal neurological deficits or mechanical complications (e.g., obstructive hydrocephalus). The present review summarises available data on the efficacy and safety of CAR-T cells for solid and haematological CNS malignancies, emphasising known and emerging phenotypes, ongoing challenges, and future perspectives. |
| format | Article |
| id | doaj-art-2fd7cc9683bc492aa2303356795b3cf5 |
| institution | DOAJ |
| issn | 2076-3425 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj-art-2fd7cc9683bc492aa2303356795b3cf52025-08-20T02:56:06ZengMDPI AGBrain Sciences2076-34252024-11-011412122010.3390/brainsci14121220CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging NeurotoxicitiesLeonardo Palazzo0Valentina Pieri1Giulia Berzero2Massimo Filippi3Neurology Unit, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyNeurology Unit, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyNeurology Unit, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyNeurology Unit, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyThe advent of chimeric antigen receptor (CAR)-T cells has recently changed the prognosis of relapsing/refractory diffuse large B-cell lymphomas, showing response rates as high as 60 to 80%. Common toxicities reported in the pivotal clinical trials include the cytokine release syndrome (CRS) and the Immune effector Cell-Associated Neurotoxicity Syndrome (ICANS), a stereotyped encephalopathy related to myeloid cell activation and blood–brain barrier dysfunction, presenting with a distinctive cascade of dysgraphia, aphasia, disorientation, attention deficits, vigilance impairment, motor symptoms, seizures, and diffuse brain oedema. The tremendous oncological efficacy of CAR-T cells observed in systemic B-cell malignancies is leading to their growing use in patients with primary or secondary central nervous system (CNS) lymphomas and in patients with solid tumours, including several CNS cancers. Early studies conducted in adult and paediatric patients with solid CNS tumours reported a distinct profile of neurotoxicity referred to as Tumour inflammation-associated neurotoxicity (TIAN), corresponding to local inflammation at the tumour site manifesting with focal neurological deficits or mechanical complications (e.g., obstructive hydrocephalus). The present review summarises available data on the efficacy and safety of CAR-T cells for solid and haematological CNS malignancies, emphasising known and emerging phenotypes, ongoing challenges, and future perspectives.https://www.mdpi.com/2076-3425/14/12/1220CAR-T cellsCNS tumoursneurotoxicityICANSTIAN |
| spellingShingle | Leonardo Palazzo Valentina Pieri Giulia Berzero Massimo Filippi CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging Neurotoxicities Brain Sciences CAR-T cells CNS tumours neurotoxicity ICANS TIAN |
| title | CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging Neurotoxicities |
| title_full | CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging Neurotoxicities |
| title_fullStr | CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging Neurotoxicities |
| title_full_unstemmed | CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging Neurotoxicities |
| title_short | CAR-T Cells for the Treatment of Central Nervous System Tumours: Known and Emerging Neurotoxicities |
| title_sort | car t cells for the treatment of central nervous system tumours known and emerging neurotoxicities |
| topic | CAR-T cells CNS tumours neurotoxicity ICANS TIAN |
| url | https://www.mdpi.com/2076-3425/14/12/1220 |
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