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Sharma et al. Neuroimmunol Neuroinflammation 2018;5:43 Neuroimmunology and
DOI: 10.20517/2347-8659.2018.51 Neuroinflammation

Review Open Access

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

Akanksha Sharma , Gustavo De Leon , Alyx Porter , Marie F Grill , Allison Rosenthal , Christine E
1,2
2
1
3
1,2
Brown , Kristin Swanson , Maciej M Mrugala 1,2
4
3
1 Department of Neurology, Mayo Clinic, Phoenix, AZ 85054, USA.
2 Division of Hematology-Oncology, Mayo Clinic, Phoenix, AZ 85054, USA.
3 Mathematical Neuro-Oncology Lab, Mayo Clinic, Phoenix, AZ 85054, USA.
4 Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory, City of Hope Beckman
Research Institute, Duarte, CA 91010, USA.
Correspondence to: Dr. Maciej M Mrugala, Department of Neurology, 5777 E Mayo Blvd, Mayo Clinic, Phoenix, AZ 85054, USA.
E-mail: mrugala.maciej@mayo.edu
How to cite this article: Sharma A, De Leon G, Porter A, Grill MF, Rosenthal A, Brown CE, Swanson K, Mrugala MM. CAR-T cell
therapy in neuro-oncology: applications and toxicity. Neuroimmunol Neuroinflammation 2018;5:43.
http://dx.doi.org/10.20517/2347-8659.2018.51

Received: 25 Aug 2018 First Decision: 13 Sep 2018 Revised: 20 Sep 2018 Accepted: 20 Sep 2018 Published: 18 Oct 2018
Science Editor: Athanassios P. Kyritsis Copy Editor: Cai-Hong Wang Production Editor: Zhong-Yu Guo

Abstract
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.

Keywords: CAR-T cell, immunotherapy, brain tumor, cytokine release syndrome

INTRODUCTION
The immune system plays many roles in cancer prevention. Not only does it protect against viral infections
and the development of virus-driven tumors, it also eliminates tumor cells, and rapidly identifies and

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
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