CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Characteristics and Clinical Outcomes of Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma Who Received At Least 3 Lines of Therapies.
Characteristics and Clinical Outcomes of Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma Who Received At Least 3 Lines of Therapies.
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在本研究中,大多数复发/难治性弥漫大 B 细胞淋巴瘤患者在三线和四线治疗中接受 CT/CIT 或 TT 治疗,临床结局不佳,凸显了对更有效治疗的需求。
从COTA数据库中选取2014年1月1日后接受3L治疗的成年DLBCL患者。按开始3L或4L治疗分组,并进一步按治疗类型分层:化疗或化学免疫治疗(CT/CIT)、靶向治疗(TT)、CAR-T 细胞,或挽救治疗后序贯造血细胞移植(HCT)。评估患者特征、缓解率及总生存期(OS)。
在复发/难治性(r/r)DLBCL成年患者中,212例接受3L治疗(平均年龄61.8岁,男性59.0%),127例接受4L治疗(平均年龄61.0岁,男性61.4%)。接受3L和4L治疗者中,分别有55.2%和50.4%接受CT/CIT,26.9%和34.6%接受TT。3L患者接受CT/CIT、TT和CAR-T 后的完全缓解率分别为9.4%、10.5%和60%;4L患者的结果相近,分别为6.3%、15.9%和53.8%。在接受药物治疗的患者中,3L和4L治疗后的中位OS分别为7.7个月和4.4个月。接受细胞治疗(CAR-T/HCT)者的中位OS尚未达到。
本研究中,多数r/r DLBCL患者在3L和4L阶段接受CT/CIT或TT治疗,临床结局较差,凸显了开发更有效治疗方法的必要性。
Adult patients diagnosed with DLBCL who received 3L after January 1, 2014 were selected from the COTA database. Patients were grouped into cohorts by 3L or 4L initiation and further stratified by type of treatment received: chemotherapy or chemoimmunotherapy (CT/CIT), targeted therapy (TT), chimeric antigen receptor T cells (CAR-T), or salvage therapy consolidated with hematopoietic cell transplant (HCT). Patient characteristics, response rates, and overall survival (OS) were examined.
Among adult patients with relapsed/refractory (r/r) DLBCL, 212 (mean age; 61.8 years; 59.0% male) received their 3L and 127 (mean age: 61.0 years; 61.4% male) their 4L. Among those treated with their 3L and 4L, 55.2% and 50.4%, respectively, received CT/CIT; 26.9% and 34.6% received TT. The complete response rate of 3L patients was 9.4% for CT/CIT, 10.5% for TT, and 60% for CAR-T. Similar findings were seen with 4L patients (CT/CIT: 6.3%; TT: 15.9%; CAR-T: 53.8%). For those who received pharmacological treatment in 3L and 4L, median OS times were 7.7 and 4.4 months, respectively. Median OS times of patients who received cell-based therapies (CAR-T/HCT) were not reached.
In this study, a majority of r/r DLBCL patients were treated with CT/CIT or TT in 3L and 4L settings and had poor clinical outcomes, underscoring the need for more effective treatments.
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