The Role of CAR T-Cells in Changing the Therapeutic Algorithm in Autoimmune Neurology*
Date: October 17, 2026
Time: 5:00 pm to 6:30 pm
Room: Pacific Jewel Ballroom
Track: Plenary - Opening Symposium
Session Description
CAR T-cell therapy is emerging as a transformative treatment for patients with refractory autoimmune neurological disorders, including myasthenia gravis, multiple sclerosis, stiff-person syndrome, NMOSD, autoimmune encephalitis, and autoimmune neuropathies. This session will provide an overview of CAR T-cell therapy, including its development, mechanisms of action, and therapeutic potential. Faculty will review how these therapies target B cells, their capacity to induce durable responses, and their potential to alter the treatment paradigm in autoimmune neurology.
The session will also highlight the latest clinical data and ongoing studies evaluating autologous CAR T-cell therapies.
Learning Objectives
At the conclusion of this session, attendees will be able to:
- Discuss the efficacy, long-term outcomes, and potential complications of CAR T-cell therapies in refractory autoimmune neurological disorders.
- Explain the mechanisms of action of CAR T-cell therapies and how they differ from existing immunotherapies.
- Evaluate the risks and benefits of CAR T-cell therapies across a range of autoimmune neurological conditions.
Speakers
- (Chair, Speaker) Marinos Dalakas, MD, PhD, FAAN, FANA
- (Co-Chair) Francesca Bagnato, MD, PhD
- (Speaker) Scott Zamvil, MD, PhD, FAAN, FANA
- (Speaker) Josep Dalmau, MD, PhD, FANA
The Role of CAR T-Cells and Why They Promise to Change the Therapeutic Algorithm in Autoimmune Neurology: Experience from Stiff Person Syndrome and Myasthenia Gravis
Description
Several patients with various autoimmune neurological diseases do not respond to available immunotherapies, even to target-specific biologics, exhibiting steadily increasing disability. For these patient subsets there is a long-standing need for novel therapies to stop or reverse disease progression. Such a revolutionary emerging new therapy is now the CAR T-cells.
The presentation will describe what are CAR T-cells, how are produced and administered, and why, by exerting global immune and durable effects, can reverse chronic disease progression and promise to change the therapeutic algorithm in patients with various, even heterogenous, autoimmune neurological disorders, such as myasthenia gravis, multiple sclerosis, stiff person syndrome, NMO-SD, autoimmune encephalitis or autoimmune neuropathies, when these patients do not respond to current immunotherapies. Experience from 26 patients with refractory stiff person syndrome and several with myasthenia gravis will be presented.
Attendees will leave with greater understanding of the CAR T-cells as a remarkably effective novel therapy for refractory autoimmune neurological disorders along with practical insights on their complexity, safety profile, durability, and the timing need to be considered to prevent further disease progression or reverse permanent disability.
CAR-T Cell Treatment in CNS Autoimmunity
Description
Chimeric antigen receptor (CAR)-T cells are rapidly being advanced for treatment of CNS autoimmune diseases and for many other conditions. Anti-CD19 and anti-BCMA CAR-T cells promote depletion of B cells at different stages of B cell differentiation. Anti-CD19 CAR-T cells target and eliminate naive, immature and mature memory B cells whereas anti-BCMA CAR-T cells eliminate antibody-secreting plasmablasts and plasmablasts.
This presentation will describe the development and immunologic basis for CAR-T cell therapy. Describing initial studies testing anti-CD19 CAR-T cells, which have shown promise in multiple sclerosis (MS), stiff person syndrome (SPS) and MOG antibody-associated disease (MOGAD). Anti-BCMA shown benefit in initial testing in neuromyelitis optica spectrum disorder (NMOSD) and could have a role in treatment of progressive MS.
Attendees will leave with a greater understanding of emerging CAR-T approaches for autoimmune diseases including allo-CAR-T and in vivo CAR-T and a perspective on next-generation cell therapies that could advance the treatment of autoimmune and CNS diseases.
CAR T-Cell Therapy in Autoimmune Encephalitides and Insights into Neurotoxicity Risk in Oncology Patients
Description
Neurologists are increasingly involved in the diagnosis and management of CAR T-cell–associated complications, particularly in the oncological setting, as well as in the expanding use of CAR T-cell therapy for autoimmune diseases such as autoimmune encephalitides (AE). However, important questions remain regarding predictors of neurotoxicity, including immune effector cell-associated neurotoxicity syndrome (ICANS), and the selection of patients with AE who may benefit from CAR T-cell therapy.
This presentation will first examine CAR T-cell–associated neurotoxicity in the context of hematological malignancies, reviewing the risk factors and clinical manifestations of ICANS and the closely related cytokine release syndrome (CRS), as well as their impact on clinical outcomes, based on a multi-institutional study of 600 patients treated with CD19-directed CAR T-cell products. The presentation will then address the emerging role of CAR T-cell therapy in antibody-mediated AE, with a particular focus on patient selection, including AE subtype, refractoriness to immunotherapy, potential for neurological recovery, and the risk of CAR T-cell–related complications.
Attendees will gain practical insights into the factors associated with CAR T-cell–associated neurological toxicities and their impact on outcomes in the oncology setting, as well as the emerging evidence supporting CAR T-cell therapy in antibody-mediated AE.
