CELL INTELLIGENCE · 肿瘤细胞治疗研究

BACKGROUND: Evidence for chimeric antigen receptor T-cell (CAR-T) therapy in primary central nervous system lymphoma (PCNSL) remains limited and heterogeneous, with prior syntheses often combining primary and secondary CNS lymphoma. METHODS: We systematically searched PubMed, Scopus, and Web of Science through February 2026. The protocol was not registered in PROSPERO. Twenty-three reports were included: 15 studies in the quantitative synthesis (194 patients) and 8 reports in the qualitative synthesis (9 patients). RESULTS: The pooled overall response rate was 68% (95% CI, 59-76; I 2 =17%), including a complete response rate of 57% (95% CI, 49-65; I 2 =4%) and a partial response rate of 16% (95% CI, 11-22; I 2 =0%). Pooled overall survival rates were 79% at 6 months and 60% at 12 months; progression-free survival rates were 52% and 42%, respectively. Safety outcomes showed pooled rates of 72% for any-grade cytokine release syndrome (CRS) and 12% for grade 3 CRS, while any-grade and grade 3 immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 46% and 16%, respectively. Treatment-related mortality was 5% (95% CI, 2-15; I 2 = 0%). Sensitivity analyses yielded comparable results. CONCLUSIONS: CAR-T therapy demonstrates promising efficacy with manageable toxicity in PCNSL. Although early disease control is encouraging, long-term durability remains limited. Primary central nervous system lymphoma (PCNSL) is a rare and aggressive cancer that develops in the brain, spinal cord, or eyes. A newer treatment called CAR-T cell therapy, which reprograms a patient s own immune cells to attack cancer, has shown promise for various lymphomas, but its effectiveness specifically in PCNSL has been unclear because prior research often lumped this disease together with lymphomas that spread to the brain from elsewhere in the body.To clarify this, researchers reviewed all available studies through February 2026 that reported outcomes for PCNSL patients treated with CAR-T therapy, combining data from 194 patients across 15 studies.The results were encouraging: about 68% of patients responded to treatment, with 57% achieving complete disappearance of detectable disease. At 6 months, 79% of patients were alive, though this declined to 60% by 12 months, and progression-free survival dropped more sharply, from 52% to 42% over the same period suggesting many responses did not last.Side effects were generally manageable. Cytokine release syndrome (an inflammatory reaction) and neurological side effects occurred but were mostly mild to moderate, with severe cases relatively uncommon. Treatment-related deaths were rare (5%).Overall, CAR-T therapy shows real promise for PCNSL, but larger, disease-specific studies are needed to help responses last longer and improve long-term outcomes.