Narrative review explores strategies to prevent CAR-T cell exhaustion in treatment-resistant non-Hodgkin lymphoma

This narrative review focuses on strategies to prevent CAR-T cell exhaustion in the context of treatment-resistant non-Hodgkin lymphoma. The scope includes modifications to CAR structure, the addition of adjunctive agents, and alternative product manufacturing strategies. The authors aim to support further research in this critical area where current evidence remains limited.

Key findings or arguments synthesized by the authors highlight various theoretical and experimental approaches to enhancing CAR-T cell persistence. However, the review does not provide pooled effect sizes or quantitative data because primary outcomes and secondary outcomes were not reported. Consequently, the discussion remains qualitative rather than quantitative.

Significant gaps and limitations are inherent to this narrative synthesis. The study phase was not reported, and no specific sample size, setting, or follow-up duration was provided. Furthermore, adverse events, tolerability, discontinuations, and serious adverse events were not reported, preventing an assessment of safety profiles for these strategies.

Practice relevance is currently aimed at supporting further research rather than guiding immediate clinical implementation. Given the lack of reported data on efficacy and safety, clinicians should interpret these strategies as areas for future investigation rather than established interventions. The review underscores the need for robust trials to validate these approaches before they can be integrated into standard care.