Ctim-26. toxicity profile of CAR-T cell therapy in glioblastoma: a meta-analysis of cytokine release syndrome, neurotoxicity, and adverse events
Abstract
Chimeric antigen receptor (CAR) T cell therapy is under investigation for glioblastoma (GBM), with early-phase trials reporting varied toxicity profiles. While CAR-T has demonstrated potential in hematologic malignancies, its safety in GBM remains incompletely characterized. This study meta-analyzes adverse event profiles, including cytokine release syndrome (CRS), neurological events, and overall toxicity in GBM.
A systematic search was conducted through May 30, 2025, using PubMed, Cochrane Library, and conference proceedings from ASCO, SNO, ESMO, and AACR. Eligible studies were clinical trials of CAR-T therapy in GBM reporting CRS, neurological events, or any grade adverse events. Pooled incidence rates were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic, with values of 0–25% considered low, 26–50% moderate, and >50% high. Between-study variance was estimated using the Q-profile method with Hartung-Knapp adjustment.
Twelve phase I trials (N=147) were analyzed. The median age was 55 years (IQR: 42.8–60.5), and 35.3% of participants were female. Dose escalation strategies were reported in 46% of studies, while the remaining 54% used fixed or predefined dosing. Routes of CAR-T administration included intravenous (46%), intraventricular (23%), intracavitary (15%), and multiple or combined routes (15%). The median time from diagnosis to CAR-T infusion was 12.0 months (IQR: 11.05–15.0). The pooled incidence of CRS was 20.3% (95% CI:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 147 participants or records.
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