Advances in CAR-T therapy for central nervous system lymphoma

Chimeric antigen receptor T-cell (CAR-T) therapy has transformed the management of relapsed/refractory B-cell lymphomas, yet its initial use in central nervous system lymphoma has been hampered by safety concerns and limited efficacy. Current data are derived from small, heterogeneous trials, with unresolved questions regarding neurotoxicity mitigation, optimal treatment timing, long-term response durability, and predictive biomarkers, precluding widespread clinical implementation. This narrative review systematically integrates peer-reviewed clinical trials, real-world retrospective datasets and preclinical mechanistic investigations to summarize the efficacy and safety profile of CAR-T in patients with PCNSL and SCNSL.