P11.03.B EFFICACY AND SAFETY OF CHIMERIC ANTIGEN RECEPTOR (CAR)-T CELL THERAPY IN PATIENTS WITH SECONDARY CNS LYMPHOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract BACKGROUND Chimeric Antigen Receptor (CAR) T-cell therapy has demonstrated efficacy in relapsed or refractory B-cell non-Hodgkin’s lymphoma (B-NHL), but its role in patients with secondary central nervous system (CNS) involvement is less established. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of CAR T-cell therapy in this specific population. MATERIAL AND METHODS PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to March 2025 to identify randomized controlled trials (RCTs) and non-randomized studies of CAR T-cell therapy in adult patients with B-NHL and secondary CNS involvement. Outcomes of interest included Complete response, CNS response, progression-free survival (PFS), overall survival (OS), and adverse events such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). RESULTS We included 19 studies with 518 patients of whom 289 had systemic disease at time of CAR-T therapy. Complete response rates were observed in 54% of patients (95% CI 0.43-0.65; I²=78%), while CNS response rates were reported in 58% of patients (95% CI 0.28-0.87; I²=89%). Proportions of adverse events including CRS (95% CI 0.72-0.96; i²=88%) and ICANS (95% CI 0.37-0.59; i²=78%) were 84% and 48%, respectively. CONCLUSION These findings suggest that CAR T-cell therapy provides significant systemic and CNS responses and reduces progression in B-NHL patients with secondary CNS involvement, though neurotoxicity remains a notable concern for neuro-oncology practice.