Evidence map›Paper›PMID 41895715›Full record

SynthesisJournal for immunotherapy of cancer2026

Locoregional delivery of CAR T cells in high-grade gliomas: a systematic analysis of safety, efficacy, and emerging biomarkers of response.

Christian K Ramsoomair, Manav Daftari, Rami Benchouia, Dagoberto Estevez-Ordonez, Anurag Aka, Vratko Himic, Manuela Aramburu-Berckemeyer, Daniel Kreatsoulas, Vaidya Govindarajan, Jay S Chandar and 3 more

Abstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal for immunotherapy of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. 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

13 authors.

Christian K RamsoomairUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA c.ramsoomair@med.miami.edu ashah@med.miami.edu.ORCID http://orcid.org/0000-0003-1147-9435
Manav DaftariUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Rami BenchouiaUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Dagoberto Estevez-OrdonezUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Anurag AkaUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.ORCID http://orcid.org/0009-0008-4252-7456
Vratko HimicUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Manuela Aramburu-BerckemeyerUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Daniel KreatsoulasUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Vaidya GovindarajanUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Jay S ChandarUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Michael E IvanUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Ricardo J KomotarUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA.
Ashish ShahUniversity of Miami Department of Neurological Surgery, Miami, Florida, USA c.ramsoomair@med.miami.edu ashah@med.miami.edu.ORCID http://orcid.org/0000-0002-0183-1274

Funding

Immuno-modulating Diffuse Midline Glioma by Epi-transcriptomic ReprogrammingF30CA301802 · NCI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Christian Kieran Ramsoomair · 2025 to 2026
$110k
NCI NIH HHS F30 CA301802
6 · The paper itself

Abstract

backgroundChimeric antigen receptor T-cell (CAR-T) therapy represents a promising frontier in oncology, but its application to high-grade gliomas (HGG) is challenged by the blood-brain barrier, limited efficacy, and significant toxicities associated with systemic administration. Locoregional delivery has the potential to address these shortcomings. This systematic review evaluates the safety and efficacy of locoregional vs systemic CAR-T cell delivery for HGG.

methodsFollowing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a total of 112 studies were identified from three separate databases between 2015 and 2024. Of these, 19 articles were assessed for eligibility, resulting in 16 articles meeting the inclusion criteria with 194 treated patients across 14 clinical trials. A comparative meta-analysis was performed to compare the safety and efficacy outcomes of locoregional administration (eg, intracerebroventricular, intratumoral) with systemic (intravenous) delivery. Severe (grade ≥3) adverse event rates and therapeutic responses were pooled to calculate crude incidence, rate ratios, and relative risks (RRs) with 95% CIs. Both fixed-effect and random-effects models were used to evaluate incidence rate ratios.

resultsLocoregional delivery was associated with a markedly improved safety profile, demonstrating an over 60% reduction in the incidence of grade ≥3 adverse events compared with systemic infusion (RR=0.39; 95% CI 0.30 to 0.52; p<0.001). Furthermore, locoregional strategies demonstrated encouraging signals of antitumor activity, including rates of disease responses not widely observed with systemic approaches (RR=3.79; 95% CI 1.23 to 11.70; p<0.05). Locoregional delivery also enables the analysis of cerebrospinal fluid to monitor T-cell trafficking and emerging biomarkers of immune activation.

conclusionIntracranial delivery of CAR-T cells helps overcome key barriers that limit the efficacy and safety of systemic therapy in brain tumors. These findings support a paradigm shift that integrates locoregional delivery techniques as a pivotal component in the design of future CAR-T cell trials, offering a safer and potentially more effective therapeutic approach with greater opportunities for longitudinal sampling for patients with HGG.

Indexed as

Brain NeoplasmsGliomaImmunotherapy, AdoptiveReceptors, Chimeric AntigenHumansNeoplasm GradingT-LymphocytesTreatment OutcomeReceptors, Chimeric AntigenChimeric antigen receptor - CARImmunotherapyNeurotoxicityT cell

Identifiers

PMID41895715
PMCPMC13034252

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.