{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:50:36Z","timestamp":1791535836062,"version":"4.3.4"},"reference-count":0,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Immune effector cell\u2013associated neurotoxicity syndrome (ICANS) is a clinically significant complication of chimeric antigen receptor T-cell (CAR-T) therapy, with reported incidence varying across products and indications. However, the overall and product-specific risks of ICANS have not been comprehensively quantified. The aim of this study was to determine the pooled incidence of any-grade and severe (grade \u22653) ICANS across FDA-approved CAR-T products used in hematologic malignancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We performed a meta-analysis of prospective and retrospective studies evaluating six FDA-approved CAR-T products (axicabtagene ciloleucel, tisagenlecleucel, lisocabtagene maraleucel, brexucabtagene autoleucel, idecabtagene vicleucel, and ciltacabtagene autoleucel). The primary endpoint was incidence of any-grade ICANS; the secondary endpoint was incidence of grade \u22653 ICANS. Pooled incidence proportions were calculated using random-effects models. Heterogeneity was assessed using Cochran\u2019s Q and I\n                      <jats:sup>2<\/jats:sup>\n                      statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty analytic cohorts including 8,411 patients were analyzed. The pooled random-effects incidence of any-grade ICANS was 29.7% (95% CI, 24.3%\u201335.5%), and grade \u22653 ICANS occurred in 9.9% (95% CI, 7.4%\u201312.8%). Heterogeneity remained substantial for any-grade ICANS (Q=1822.40; I\n                      <jats:sup>2<\/jats:sup>\n                      =96.76%; \u03c4\n                      <jats:sup>2<\/jats:sup>\n                      =0.22) and grade \u22653 ICANS (Q=965.44; I\n                      <jats:sup>2<\/jats:sup>\n                      =93.89%; \u03c4\n                      <jats:sup>2<\/jats:sup>\n                      =0.11).Incidence varied markedly by product, with highest rates observed in CD28-based CD19 CAR-T therapies (axicabtagene ciloleucel and brexucabtagene autoleucel) and lower rates in 4-1BB\u2013based CD19 and BCMA-targeted therapies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Approximately one in four CAR-T recipients develop ICANS, with nearly one in ten experiencing severe neurotoxicity. Risk varies significantly by product, supporting the need for product-specific risk stratification, monitoring strategies, and toxicity mitigation approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10815589261497365","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:40:23Z","timestamp":1791434423000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["EXPRESS: Immune Effector Cell-Associated Neurotoxicity Syndrome in Hematological Malignancy Patients Treated with CAR-T Cell: A Systematic Review"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2417-7981","authenticated-orcid":false,"given":"Kareem","family":"Latif","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Cha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Niihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Dastjerdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojtaba","family":"Akhtari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"container-title":["Journal of Investigative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10815589261497365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10815589261497365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:17:17Z","timestamp":1791533837000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10815589261497365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":0,"alternative-id":["10.1177\/10815589261497365"],"URL":"https:\/\/doi.org\/10.1177\/10815589261497365","relation":{},"ISSN":["1081-5589","1708-8267"],"issn-type":[{"value":"1081-5589","type":"print"},{"value":"1708-8267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"10815589261497365"}}