{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T19:09:45Z","timestamp":1779304185384,"version":"3.51.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Immune effector cell\u2013associated neurotoxicity syndrome (ICANS) is a frequent complication of chimeric antigen receptor (CAR) T-cell therapy. Most patients achieve complete symptom resolution without long-term neurological sequelae, yet the impact of ICANS and steroid therapy on oncological outcomes remains inadequately explored. We investigated the association between ICANS and steroid therapy with progression-free survival (PFS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included large B-cell lymphoma patients treated with anti-CD19 CAR T cells. The primary outcome was 90-day PFS. The secondary outcomes included PFS, complete response, and overall survival (OS) at 30, 90, 180, and 365 days. The association between outcomes and ICANS and steroid treatment was assessed using logistic regression analyses adjusted for baseline factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 241 patients were included. The median age was 60 years (interquartile range [IQR]\u2005=\u200551\u201366), 81 (33.6%) were females, 67 (27.8%) developed ICANS, and 142 (58.9%) achieved 90-day PFS. There was no association between 90-day PFS and ICANS development (adjusted odds ratio [aOR] 1.39 [95% confidence interval {CI}\u2005=\u20050.75\u20132.61]), maximum grade (aOR 1.24 [0.97\u20131.59]), duration (aOR 1.00 [95% CI\u2005=\u20050.95\u20131.05] per 1-day increase), or day of onset (aOR 0.98 [95% CI\u2005=\u20050.86\u20131.11] per 1-day increase). There was no association between 90-day PFS and steroid therapy (aOR 1.25 [95% CI\u2005=\u20050.73\u20132.14]) or cumulative dose (aOR 1.00 [95% CI\u2005=\u20050.98\u20131.01] per 100-mg increase). Similar results were observed for secondary outcomes, except for an association between ICANS and OS at 30 days (aOR 0.05 [95% CI\u2005=\u20050.01\u20130.54]) and 90 days (aOR 0.35 [95% CI\u2005=\u20050.15\u20130.80]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings suggest that ICANS and steroid therapy do not adversely impact the PFS in lymphoma patients receiving anti-CD19 CAR T cells. Yet, ICANS might be associated with reduced early OS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/nop\/npae128","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T06:56:51Z","timestamp":1735628211000},"page":"531-539","source":"Crossref","is-referenced-by-count":1,"title":["Impact of neurotoxicity and steroid therapy on cancer progression-free survival in lymphoma patients treated with anti-CD19 CAR T cells"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4042-4735","authenticated-orcid":false,"given":"Umberto","family":"Pensato","sequence":"first","affiliation":[{"name":"IRCCS Humanitas Research Hospital , Milan ,","place":["Italy"]},{"name":"Department of Biomedical Sciences, Humanitas University , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6827-0099","authenticated-orcid":false,"given":"Lorenzo","family":"Muccioli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna , Bologna ,","place":["Italy"]},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Taurino","sequence":"additional","affiliation":[{"name":"BMT and Cell Therapy Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Pondrelli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna , Bologna ,","place":["Italy"]},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Maria","family":"Asioli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna , Bologna ,","place":["Italy"]},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"de Philippis","sequence":"additional","affiliation":[{"name":"BMT and Cell Therapy Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Mannina","sequence":"additional","affiliation":[{"name":"BMT and Cell Therapy Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianmarco","family":"Bagnato","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche e Chirurgiche, Universit\u00e0 di Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Marcheselli","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pier Luigi","family":"Zinzani","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia \u201cSer\u00e0gnoli,\u201d Bologna ,","place":["Italy"]},{"name":"Dipartimento di Scienze Mediche e Chirurgiche, Universit\u00e0 di Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Bonifazi","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia \u201cSer\u00e0gnoli,\u201d Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Bramanti","sequence":"additional","affiliation":[{"name":"BMT and Cell Therapy Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital , Milan ,","place":["Italy"]},{"name":"IRCCS Humanitas Research Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Guarino","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna , Bologna ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"issue":"1","key":"2025060501014211900_CIT0001","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/nrclinonc.2017.128","article-title":"Chimeric antigen receptor T-cell therapies for lymphoma","volume":"15","author":"Brudno","year":"2018","journal-title":"Nat Rev Clin Oncol."},{"issue":"1","key":"2025060501014211900_CIT0002","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/nrclinonc.2017.148","article-title":"Chimeric antigen receptor T-cell therapy\u2014assessment and management of toxicities","volume":"15","author":"Neelapu","year":"2018","journal-title":"Nat Rev Clin Oncol."},{"issue":"4","key":"2025060501014211900_CIT0003","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.bbmt.2018.12.758","article-title":"ASTCT consensus grading for cytokine release syndrome and neurologic toxicity 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