Bibliographic Details
| Title: |
Incidence of immune effector cell-associated neurotoxicity among patients treated with CAR T-cell therapy for hematologic malignancies: systematic review and meta-analysis |
| Authors: |
Min Woo Han, So Yeong Jeong, Chong Hyun Suh, Hyesun Park, Jeffrey P. Guenette, Raymond Y. Huang, Kyung Won Kim, Dok Hyun Yoon |
| Source: |
Frontiers in Neurology, Vol 15 (2024) |
| Publisher Information: |
Frontiers Media S.A., 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Neurology. Diseases of the nervous system |
| Subject Terms: |
CAR T-cell, immunotherapy, immune effector cell-associated neurotoxicity syndrome, neurotoxicity, hematologic malignancies, Neurology. Diseases of the nervous system, RC346-429 |
| More Details: |
ObjectivesWe aim to assess the pooled incidence of immune effector cell-associated neurotoxicity syndrome (ICANS) in clinical trials and real-world studies of chimeric antigen receptor (CAR) T-cell therapy for hematologic malignancy and compare the incidences among different agents.MethodsThe PubMed, Embase, and Web of Science databases were searched for clinical trials and real-world studies. An inverse-variance weighting model was used to calculate pooled incidences and subgroup analyses. Multivariable analysis was conducted using binomial-normal modeling.ResultsSeventy-five trials comprising 3,184 patients were included. The overall pooled incidence was 26.9% (95% CI, 21.7–32.7%) for all-grade and 10.5% (95% CI, 8.1–13.6%) for high-grade ICANS. In subgroup analysis, cohorts with anti-CD19 drugs had significantly higher ICANS incidences than cohorts with other agents. The multivariable analysis demonstrated higher odds of ICANS in anti-CD19 drug studies for high-grade (OR, 4.6) compared to anti-BCMA drug studies. In 12 real-world studies, studies used axicabtagene ciloleucel with CD28 (54.0% all-grade, 26.4% high-grade) exhibited significantly higher rates of all-grade and high-grade ICANS than studies using tisagenlecleucel with 4-1BB (17.2% all-grade, 6.1% high-grade).ConclusionsThe overall incidences of ICANS with CAR T-cell therapy were 26.9% for all-grade and 10.5% for high-grade. Compared with other agents, patients with anti-CD19 drugs had a significantly increased risk of developing high-grade ICANS. Therefore, careful monitoring of ICANS should be considered for patients undergoing CAR T-cell therapy. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1664-2295 |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fneur.2024.1392831/full; https://doaj.org/toc/1664-2295 |
| DOI: |
10.3389/fneur.2024.1392831 |
| Access URL: |
https://doaj.org/article/c9c414da47c743598a43fbd7ba941cb5 |
| Accession Number: |
edsdoj.9c414da47c743598a43fbd7ba941cb5 |
| Database: |
Directory of Open Access Journals |
