CAR-T cell therapy in neuro-oncology: applications and toxicity

A new era for cancer treatment has been ushered in with the field of cancer immunotherapy. After initial success with systemic malignancies, several of these promising treatments are being investigated for efficacy with primary and secondary brain tumors. Chimeric antigen receptor (CAR) T cells are being studied, both with systemic infusion and direct administration to the tumor and into the cerebrospinal fluid, with promising early results. Systemic CAR-T treatment can have serious systemic and neurological toxicities that are important for the practicing neurologist and neuro-oncologist to know and understand. This review aims to discuss adoptive cell therapies with a focus on CAR-T treatment. We review use of this therapy in brain cancers, particularly malignant glioma, and provide an overview of the toxicity of CAR-T treatment and its appropriate management.