2026-10-11T19:12:26Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33992263 2026-09-25T04:27:49Z category_388 portal_316 item_type_3 month_year_09_2026

Table 2_Efficacy and safety of immunotherapy in pediatric malignant brain tumors: a systematic review and exploratory meta-analysis.docx Tomasz Tykocki (23952791) Oncology and Carcinogenesis not elsewhere classified CAR-T immunotherapy neurotoxicity overall survival pediatric brain tumors Background<p>Immunotherapy for pediatric brain tumors has expanded rapidly, yet its effects on survival and neurologic safety remain unclear. A systematic review and meta-analysis was conducted to quantify efficacy and toxicity across immunotherapy modalities.</p>Methods<p>Following PRISMA 2020 guidelines, prospective pediatric immunotherapy studies were identified. Random-effects meta-analyses were performed using vaccine-based immunotherapy as the reference. Primary endpoints were overall survival (OS) and 12-month overall survival (OS12); grade ≥3 neurotoxicity was the primary safety outcome. Meta-regression and sensitivity analyses explored modality-specific effects.</p>Results<p>Twenty studies were included. Median OS ranged from 3.6 months in heavily pretreated recurrent cohorts to 17.8 months in selected intratumoral oncolytic virus trials, while OS12 ranged from 8–13% to 75%. Compared with vaccines, non-vaccine immunotherapy did not improve OS (pooled HR 1.14, 95% CI 0.99–1.31; I² 43%) or OS12 (HR 1.13, 95% CI 0.95–1.34; I² 65%). Subgroup analyses showed comparable OS for CAR-T therapies (OS HR 1.09, 95% CI 0.89–1.34) and checkpoint/systemic therapies (OS HR 1.14, 95% CI 0.96–1.36), or oncolytic/viral therapies (OS HR 1.51, 95% CI 0.81–2.84). Severe neurotoxicity differed substantially by modality. No grade ≥3 neurotoxicity occurred in vaccine studies. In contrast, pooled non-vaccine therapies showed a markedly increased risk (OR 19.66, 95% CI 6.78–57.02; I² 60%). CAR-T therapies (OR 57.95, 95% CI 16.15–207.98) and oncolytic/viral approaches (OR 69.41, 95% CI 17.00–283.33) had the highest risk, whereas checkpoint/systemic therapy showed a lower, non-significant increase (OR 2.26, 95% CI 0.77–6.60).</p>Conclusions<p>Across pediatric immunotherapy trials, survival outcomes were comparable to vaccine-based approaches, but neurotoxicity varied markedly by modality. Cellular and oncolytic therapies carry a substantial neurologic risk that must be balanced against uncertain survival benefit in future trial designs.</p> 2026-09-25T04:27:49Z Dataset Dataset 10.3389/fonc.2026.1932372.s002 https://figshare.com/articles/dataset/Table_2_Efficacy_and_safety_of_immunotherapy_in_pediatric_malignant_brain_tumors_a_systematic_review_and_exploratory_meta-analysis_docx/33992263 CC BY 4.0