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Neurotoxicity of Cancer Immunotherapies Including CAR T Cell Therapy

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Abstract

Purpose of Review

To outline the spectrum of neurotoxicity seen with approved immunotherapies and in pivotal clinical trials including immune checkpoint inhibitors, chimeric antigen receptor T-cell therapy, vaccine therapy, and oncolytic viruses.

Recent Findings

There has been an exponential growth in new immunotherapies, which has transformed the landscape of oncology treatment. With more widespread use of cancer immunotherapies, there have also been advances in characterization of its associated neurotoxicity, research into potential underlying mechanisms, and development of management guidelines. Increasingly, there is also mounting interest in long-term neurologic sequelae.

Summary

Neurologic complications of immunotherapy can impact every aspect of the central and peripheral nervous system. Early recognition and treatment are critical. Expanding indications for immunotherapy to solid and CNS tumors has led to new challenges, such as how to reliably distinguish neurotoxicity from disease progression. Our evolving understanding of immunotherapy neurotoxicity highlights important areas for future research and the need for novel immunomodulatory therapeutics.

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Authors and Affiliations

  1. Department of Neurology, Stanford University School of Medicine, 453 Quarry Rd, 2nd Floor, Stanford, CA, 94305, USA

    Kun-Wei Song & Brian J. Scott

  2. Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA

    Eudocia Q. Lee

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Dr. Song, Dr. Scott, and Dr. Lee have all contributed to the conception, writing, revision, and final approval of the text, tables, and figure.

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Song, KW., Scott, B.J. & Lee, E.Q. Neurotoxicity of Cancer Immunotherapies Including CAR T Cell Therapy. Curr Neurol Neurosci Rep 23, 827–839 (2023). https://doi.org/10.1007/s11910-023-01315-w

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