SynthesisEuropean journal of pediatrics2026
Systemic versus intracranial immunotherapy delivery in pediatric malignant brain tumors: a systematic review, meta-analysis, and meta-regression.
Synthesis in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Immunotherapy has emerged as a promising strategy for pediatric high-grade gliomas and diffuse midline gliomas, yet the clinical impact of delivery route remains uncertain. This study evaluated whether intracranial or systemic administration influences survival and toxicity outcomes. A systematic review and meta-analysis were conducted according to PRISMA guidelines. Clinical studies reporting survival or toxicity outcomes of immunotherapy in pediatric brain tumors were identified. Random-effects models were used to pool hazard ratios (HRs) for overall survival (OS) and 12-month survival (OS12), and odds ratios (ORs) for grade ≥ 3 neurotoxicity. Meta-regression assessed the influence of delivery route. Twenty-two studies were included in the quantitative synthesis. Intracranial delivery showed a pooled HR for OS of 1.12 (95% CI 0.88-1.42) with moderate heterogeneity (I
conclusionsImmunotherapy delivery route does not appear to influence survival outcomes. Although intracranial administration was associated with higher reported rates of severe neurotoxicity, this finding should be interpreted cautiously given the heterogeneity of immunotherapy platforms and the potential confounding effect of treatment modality. Future studies should prioritize biologically guided therapeutic strategies while carefully balancing locoregional exposure and safety. WHAT IS KNOWN: • Locoregional (intracranial) immunotherapy has been proposed to improve CNS drug delivery in pediatric high-grade and diffuse midline gliomas, but its benefit over systemic administration is unproven. • Early-phase trials show biological activity with heterogeneous survival and toxicity, leaving the clinical impact of delivery route uncertain. WHAT IS NEW: • Across 22 studies, immunotherapy delivery route was not associated with overall or 12-month survival (rHR 0.93 and 0.87, both non-significant). • Intracranial delivery carried markedly higher severe neurotoxicity, but meta-regression showed this was largely driven by treatment platform (CAR-T/oncolytic) rather than route itself.
Indexed as
Identifiers
42283902What OpenQuestion holds
Registered trials
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.