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CAR T-cell Therapy for Central Nervous System Lymphoma
Caroline Houillier1, Sylvain Choquet2
1Neurooncology Department, Groupe Hospitalier Pitié-Salpêtrière, APHP, Sorbonne Université, Inserm, CNRS, UMR S 1127, ICM, IHU, Paris, France. caroline.houillier@aphp.fr.
Current Oncology Reports
|October 28, 2024
Summary
Chimeric antigen receptor (CAR) T-cell therapy shows high response rates for central nervous system (CNS) lymphomas. Despite neurotoxicity concerns, the therapy is promising for CNS lymphomas with a manageable safety profile.
Area of Science:
- Hematology
- Oncology
- Immunotherapy
Background:
- Anti-CD19 CAR T-cell therapy is effective for systemic diffuse large B-cell lymphomas.
- Central nervous system (CNS) lymphomas were previously excluded from trials due to neurotoxicity fears.
Purpose of the Study:
- To evaluate the efficacy and safety of CAR T-cell therapy in CNS lymphomas.
- To review recent studies on CAR T-cell treatment for primary and secondary CNS lymphomas.
Main Methods:
- Systematic review of published studies on CAR T-cell therapy for CNS lymphomas.
- Analysis of response rates, progression-free survival (PFS), and neurotoxicity.
Main Results:
- High response rates (32-67% complete response) observed in heavily pre-treated CNS lymphoma patients.
- One-year PFS rates of 40-60% reported in multiple studies.
- Neurotoxicity occurred in 36-68% of patients, with severe (grade 3-4) neurotoxicity in 4.5-29%.
Conclusions:
- CAR T-cell therapy demonstrates promising efficacy in CNS lymphomas, comparable to systemic lymphomas.
- The observed toxicity profile, including neurotoxicity, is manageable and supports further development for CNS lymphomas.
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