Evidence map›Paper›PMID 41171480›Full record

ReviewJournal of neuro-oncology2025

Neurotoxicity in central nervous system tumors treated with CAR T cell therapy: a review.

Jasia Mahdi, Juliane A Gust, Nicholas A Vitanza, Brian Scott, Michelle Monje, Rebecca Ronsley

Abstract readReview
PubMed Publisher
In one paragraph

Review in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jasia MahdiDivision of Child Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Juliane A GustDepartment of Neurology, Seattle Children's Hospital and the University of Washington, Seattle, WA, USA.
Nicholas A VitanzaDepartment of Pediatrics, Seattle Children's Hospital, University of Washington, MB.8.501, PO Box 5371, Seattle, WA, 98145-5005, USA.
Brian ScottDepartment of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA.
Michelle MonjeDepartment of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA.
Rebecca RonsleyDepartment of Pediatrics, Seattle Children's Hospital, University of Washington, MB.8.501, PO Box 5371, Seattle, WA, 98145-5005, USA. Rebecca.ronsley@seattlechildrens.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChimeric antigen receptor (CAR) T cell therapy has revolutionized treatment for hematologic malignanciesand is now being applied to central nervous system (CNS) tumors. As experience grows, distinct neurotoxicities are emerging that differ from those observed in systemic CAR T cell therapy. Understanding these toxicities is critical for optimizing safety and advancing clinical translation.

methodsWe reviewed preclinical data and early-phase clinical trials of CAR T cell therapy for CNS tumors, focusing on the characterization, mechanisms, and management of treatment-associated neurotoxicity. Three major categories were examined: immune effector cell–associated neurotoxicity syndrome (ICANS), tumorinflammation–associated neurotoxicity (TIAN), and other non-ICANS neurotoxicities (NINTs), including movement and neurocognitive treatment-emergent events.

resultsICANS reflects a global, cytokine-mediated process, whereas TIAN represents localized inflammation at the tumor site, producing either mechanical (type 1) or electrophysiologic (type 2) neurologic dysfunction. TIAN is common across phase I trials of locoregional CAR T cell therapy for CNS tumors, often transient and reversible, and may require corticosteroids, IL-1 blockade, or cerebrospinal fluid diversion. ICANS remains uncommon in this setting. Emerging data also suggest microglial activation and neurocognitive effects paralleling chemotherapy-related cognitive impairment.

conclusionCAR T cell therapy for CNS tumors induces unique neurotoxicities reflecting local immune activation within the brain. Differentiating ICANS from TIAN is essential for appropriate management. Standardized grading criteria, prospective neurocognitive monitoring, and rational CAR design are critical next steps in safely advancing CAR T cell therapy in neuro-oncology.

Indexed as

Central Nervous System NeoplasmsImmunotherapy, AdoptiveNeurotoxicity SyndromesAnimalsHumansReceptors, Chimeric AntigenReceptors, Chimeric AntigenChimeric antigen receptor T cell therapy (CAR T)Clinical trialDiffuse midline gliomaImmunotherapyNeurotoxicityPediatric

Identifiers

PMID41171480

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.