CAR-based cellular therapy for refractory systemic lupus erythematosus: an overlap-controlled systematic review - Report - MDSpire

CAR-based cellular therapy for refractory systemic lupus erythematosus: an overlap-controlled systematic review

  • By

  • Sheng-Guang Li

  • Ruohan Yu

  • Lina Zhang

  • Jing Zhang

  • Yadan Zou

  • Ji Li

  • Ting Long

  • Yanfeng Zhang

  • Jing Pan

  • July 1, 2026

  • 0 min

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Clinical Report: Systematic Review of CAR T-Cell Therapy for Refractory SLE

Overview

This systematic review evaluates CAR-based cellular therapy for refractory systemic lupus erythematosus (SLE). The analysis reveals a predominantly female cohort with significant renal involvement and varying endpoint evaluability.

Background

Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can lead to severe multi-organ damage, particularly in patients with refractory forms. Current treatment options often fail to achieve durable remission, especially in cases involving lupus nephritis. CAR T-cell therapy represents a novel approach in these challenging cases.

Data Highlights

OutcomePatients EvaluatedResponse
Clinical response45100%
DORIS remission1586.7%
SLE Responder Index-4 response20100%
Renal improvement5100%
Drug-free remission5848.3%

Key Findings

  • Twenty-one independent study units with 114 patients were included in the review.
  • The cohort was predominantly female (87.7%) with a median age of 32 years.
  • Renal involvement was present in 78.1% of patients.
  • Clinical response was documented in all evaluable patients (45/45).
  • Cytokine release syndrome was mostly low grade, with severe toxicities occurring in select cases.
  • Endpoint evaluability varied significantly across studies, highlighting the need for standardized reporting.

Clinical Implications

The findings highlight the variability in endpoint evaluability and the early stage of evidence.

Conclusion

Current evidence is limited and requires further investigation through well-designed prospective studies.

Related Resources & Content

  1. Blood Cancer Journal, Comparative Analysis of CAR-T Therapy and Bispecific Antibodies, 2025 -- Title
  2. Bone Marrow Transplantation, CAR-T Therapy for Lymphoma, 2023 -- Title
  3. The ASCO Post, CAR T-Cell Therapy Makes Further Inroads in Lymphoma and Myeloma, 2017 -- Title
  4. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update, Annals of the Rheumatic Diseases -- Title
  5. CD19 CAR-T cells for treatment-refractory autoimmune diseases: the phase 1/2 CASTLE basket trial, Nature Medicine -- Title
  6. The ASCO Post — CAR T-Cell Therapy for DLBCL: At the Crossroads of Hype and Reality
  7. EULAR recommendations for SLE management
  8. Phase 1/2 CASTLE trial results
  9. Co-infusion of CD19-targeting and BCMA-targeting CAR-T cells for treatment-refractory systemic lupus erythematosus: a phase 1 trial | Nature Medicine
  10. Allogeneic CD19-targeting T cells for treatment-refractory systemic lupus erythematosus: a phase 1 trial | Nature Medicine
  11. CD19 CAR T-Cell Therapy in Autoimmune Disease — A Case Series with Follow-up | New England Journal of Medicine

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