决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Safety and Efficacy of Chimeric Antigen Receptor T-Cell Therapy for Glioblastoma: A Systemic Review and Meta-Analysis.
尽管CAR T细胞疗法在胶质母细胞瘤患者中是一种相对安全的治疗选择,但其疗效有限,提示有必要进一步研究以将其转化为复发性胶质母细胞瘤治疗的临床实践。
背景:嵌合抗原受体(CAR)T 细胞疗法是难治性血液系统恶性肿瘤患者的一种有前景治疗选择,但其治疗胶质母细胞瘤的疗效尚不明确。本文开展系统综述,总结 CAR T 细胞疗法治疗胶质母细胞瘤的安全性和疗效。 方法:检索 PubMed、EMBASE 和 Cochrane 数据库,纳入截至 2021 年 6 月 30 日发表、描述 CAR T 细胞疗法用于胶质母细胞瘤的文章,并总结治疗毒性。采用随机效应模型及逆方差加权模型估算接受 CAR T 细胞治疗患者的合并客观缓解率(ORR),使用分位数估计法估算总生存期(OS)。 结果:在检出的 397 篇文章中,纳入 8 项研究,共 63 例接受不同 CAR T 方案治疗的复发性胶质母细胞瘤患者。6 例(9.5%)发生 2 级细胞因子释放综合征,16 例(25.4%)出现非危重神经系统事件。合并 ORR 为 5.1%(95% 置信区间 [CI]:0.0–10.4;I²=0.05%),合并 OS 中位数为 8.1 个月(95% CI:6.7–9.5;I²=0.00%)。 结论:CAR T 细胞疗法用于胶质母细胞瘤患者相对安全,但疗效有限;因此仍需进一步研究,才能将其转化为治疗复发性胶质母细胞瘤的临床实践。
BACKGROUND: Chimeric antigen receptor (CAR) T-cell therapy is a promising treatment option for patients with refractory hematological malignancies. However, its efficacy in glioblastoma remains unclear. Here, we performed a systematic review to summarize the safety and efficacy of CAR T-cell therapy in glioblastoma. METHODS: The PubMed, EMBASE, and Cochrane databases were searched to identify articles published before June 30, 2021 describing the use of CAR T-cell therapy in glioblastoma. Information on the toxicity of CAR T-cell therapy was summarized. The pooled objective response rate (ORR) and overall survival (OS) of patients who underwent CAR T-cell therapy were estimated using a random-effects model with an inverse-variance weighting model and quantile estimation method, respectively. RESULTS: Of 397 articles identified, eight studies including 63 patients with recurrent glioblastoma treated with various CAR T-cell regimens were included in the analysis. Six (9.5%) patients developed cytokine release syndrome (grade 2), and 16 (25.4%) experienced non-critical neurological events. The pooled ORR was 5.1% (95% confidence interval [CI], 0.0-10.4; I 2 = 0.05%), and the pooled median OS was 8.1 months (95% CI, 6.7-9.5; I 2 = 0.00%). CONCLUSION: Although CAR T -cell therapy is a relatively safe therapeutic option in patients with glioblastoma, it shows marginal efficacy, suggesting that further research is necessary for its translation into clinical practice for the treatment of recurrent glioblastoma.
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