BRAIN AND NERVOUS SYSTEM: Edited by Marc SansonNeurological complications of chimeric antigen receptor T cells and immune-checkpoint inhibitors: ongoing challenges in daily practiceBerzero, Giuliaa,b,∗; Picca, Albertoa,b,∗; Psimaras, Dimitric,d,eAuthor Information aNeuroncology Unit, IRCCS Mondino Foundation bDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy cService de Neurologie 2-Mazarin, AP-HP Groupe Hospitalier Pitié-Salpêtrière dSorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière (ICM) eOncoNeuroTox Group, Center for Patients with Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpetrière-Charles Foix et Hôpital Percy, Paris, France Correspondence to Giulia Berzero, MD, Neuroncology Unit, IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Italy. Tel: +39 382 380420; fax: +39 382 380226; e-mail: firstname.lastname@example.org Current Opinion in Oncology: November 2020 - Volume 32 - Issue 6 - p 603-612 doi: 10.1097/CCO.0000000000000681 Buy Metrics Abstract Purpose of review The aim of this review is to summarize the most recent advances in the management of neurological toxicities associated with immune-checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR)-T cells. Recent findings The advent of cancer immunotherapies has dramatically improved the prognosis of several refractory and advanced neoplasms. Owing to their mechanism of action, cancer immunotherapies have been associated with a variety of immune-related adverse events (irAE). Neurological irAE are uncommon compared with other irAE, but they are associated with significant morbidity and mortality. Despite the efforts to draft common protocols and guidelines, the management of neurological irAE remains challenging. Our ability to predict the development of neurotoxicity is still limited, hampering to elaborate prevention strategies. Treatment heavily relies on the administration of high-dose corticosteroids that, however, have the potential to impair oncological efficacy. The experimentation of novel strategies to avoid resorting to corticosteroids is hindered by the lack of an adequate understanding of the pathogenetic mechanisms driving the development of irAE. Summary In this review, we will discuss the most recent advances on the diagnosis and management of neurological irAE associated with ICIs and CAR-T cells, focusing on the issues that remain most challenging in clinical practice. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.