SynthesisFrontiers in immunology2025
Biomarkers for predicting CAR-T cell therapy outcomes in B-cell acute lymphoblastic leukemia: a systematic review.
Synthesis in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Early Immune Signature Features, Including TLR2 and TLR4 Expression, Are Associated with Complete Remission After CD19 CAR-T Cell Therapy.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Biomarker-empowered precision navigation of CAR-T cell therapy.Molecular cancer · 2026Review
- Precision immunotherapy with CAR-T cells in pediatric B-cell acute lymphoblastic leukemia: advances and unanswered challenges.Frontiers in oncology · 2025Review
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL), yet challenges such as cytokine release syndrome (CRS), neurotoxicity (ICANS), and variable long-term efficacy persist. This systematic review evaluates the role of biomarkers in predicting CAR-T therapy outcomes, toxicity risks, and guiding personalized treatment strategies. Methods: Following PRISMA guidelines, we systematically searched PubMed, Web of Science, and Embase for studies published between 2018-2024. A total of 33 studies involving 2,095 patients were included in the analysis. Results: Key findings identified tumor burden and minimal residual disease (MRD) as dual-predictive biomarkers. High tumor burden (≥40% blasts) correlated with reduced complete remission rates (87% vs. 100%) and increased CRS/ICANS risks, while MRD negativity (NGS threshold <10⁻⁶) predicted superior 2-year event-free survival (68% vs. 23%). CAR-T functional parameters, including PD-1/LAG-3 expression (>5.2% in CD4+ cells) and peak expansion kinetics, linked efficacy to toxicity trade-offs. Genetic biomarkers (IKZF1 mutations, complex karyotypes) and biochemical indicators (m-EASIX >6.2, ferritin ≥10,000 ng/mL) further stratified risks. Unidirectional efficacy biomarkers included T-cell subsets (e.g., CD8+ naive T cells) and B-cell aplasia, while IL-6 dynamics specifically predicted CRS severity. Discussion: Despite promising insights, heterogeneity in toxicity grading systems, inconsistent biomarker thresholds, and retrospective study designs limit clinical standardization. Future directions emphasize cytoreductive bridging therapies, biomarker-guided combinatorial approaches (e.g., MDM2 inhibitors for TP53 mutations), and multicenter validation of integrated predictive models to optimize personalized CAR-T therapy strategies.
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