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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
CAR-T 细胞治疗前淋巴瘤肿瘤负荷：RECIL 与 Lugano 与代谢肿瘤评估的比较
英文原题：Lymphoma tumor burden before chimeric antigen receptor T-Cell treatment: RECIL vs. Lugano vs. metabolic tumor assessment.
查看英文原题
Lymphoma tumor burden before chimeric antigen receptor T-Cell treatment: RECIL vs. Lugano vs. metabolic tumor assessment.
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
研究概要
CAR-T 前 TB 指标因评估方法不同而存在显著差异，这影响了其与生存结局的关联。TB RECIL、TB Lugano 与 TB MTV 之间的相关性受疾病表型和既往桥接治疗的影响。在临床试验中解读 TB 对结局的影响时，必须考虑 TB 的评估方法。鉴于其异质性，我们的结果表明需要在各中心之间实现标准化和统一化。
研究思路结论见上方概要
目的
高肿瘤负荷已成为难治或复发性大B细胞淋巴瘤患者CAR-T 细胞治疗（CAR-T）疗效的负面预测因素。本研究分析了基于影像学的肿瘤负荷（TB）指标之间的差异及其与无进展生存期（PFS）和总生存期（OS）的关联。
方法
在这项单中心观察性研究中，我们连续纳入了所有接受CD19 CAR-T 治疗且具有可用基线PET-CT影像的患者。基于影像的TB根据淋巴瘤反应评估标准（RECIL）、Lugano标准以及代谢肿瘤体积来确定。根据各自标准，总TB、结内TB和结外TB分别由最长直径之和（TB RECIL）、垂直直径乘积之和（TB Lugano）和代谢肿瘤体积（TB MTV）表示。采用相关性统计进行比较。比例Cox回归分析研究了TB指标与PFS和OS的关联。
结果
共纳入34例连续患者（中位年龄：67岁，41%为女性），总中位基线TB RECIL为12.5 cm，TB Lugano为4,030 mm²，TB MTV为330 mL。TB RECIL和TB Lugano与TB MTV的相关性较强（=0.744，p<0.001和=0.741，p<0.001），其中结外TB RECIL与TB MTV的相关性最低（=0.660，p<0.001）。PFS分层在总TB MTV>50%时最强（HR=2.915，p=0.042），而总TB RECIL>50%和总TB Lugano>50%均不显著（两者p>0.05）。所有总TB指标均与OS无关（所有p>0.05）。
展开英文摘要原文
PURPOSE
High tumor burden has emerged as a negative predictor of efficacy in chimeric antigen receptor T-cell therapy (CART) in patients with refractory or relapsed large B-cell lymphoma. This study analyzed the deviation among imaging-based tumor burden (TB) metrics and their association with progression-free (PFS) and overall survival (OS).
MATERIALS AND METHODS
In this single-center observational study, we included all consecutively treated patients receiving CD19 CART with available baseline PET-CT imaging. Imaging-based TB was determined based on response evaluation criteria in lymphoma (RECIL), the Lugano criteria, and metabolic tumor volume. Total, nodal and extranodal TB were represented, according to the respective criteria, by sum of longest diameters (TB RECIL ), sum of product of perpendicular diameters (TB Lugano ), and metabolic tumor volume (TB MTV ). Correlation statistics were used for comparison. Proportional Cox regression analysis studied the association of TB metrics with PFS and OS.
RESULTS
34 consecutive patients were included (median age: 67 years, 41% female) with total median baseline TB RECIL of 12.5 cm, TB Lugano of 4,030 mm 2 and TB MTV of 330 mL. The correlation of TB RECIL and TB Lugano with TB MTV was strong ( =0.744, p<0.001 and =0.741, p<0.001), with lowest correlation for extranodal TB RECIL with TB MTV ( =0.660, p<0.001). Stratification of PFS was strongest by total TB MTV>50% (HR=2.915, p=0.042), whereas total TB RECIL>50% and total TB Lugano>50% were not significant (both p>0.05). None of the total TB metrics were associated with OS (all p>0.05).
CONCLUSION
Pre-CART TB metrics vary significantly based on the assessment method, impacting their association with survival outcomes. The correlation between TB RECIL , TB Lugano and TB MTV was influenced by disease phenotype and prior bridging therapy. TB method of assessment must be considered when interpreting the impact of TB on outcomes in clinical trials. Considering the heterogeneity, our results argue for standardization and harmonization across centers.
论文信息
- 作者
- Winkelmann M、Bücklein VL、Blumenberg V、Rejeski K、Ruzicka M、Unterrainer M、Schmidt C、Dekorsy FJ
- 单位
- Department of Radiology, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany.Germany
- 期刊
- Frontiers in oncology2022
- 原文标识
- PubMed 36158658 · DOI 10.3389/fonc.2022.974029
在 PubMed 查看 → 出版商原文（DOI） 全文 PDF（PMC）· 可下载 治疗专题与资料阅读指南 资料来源与翻译说明 报告译文或资料问题 →