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血液系统恶性肿瘤中的 CAR-T 细胞治疗与患者报告结局:范围综述

英文原题:Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review.

查看英文原题

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review.

PubMed 2022/12/01(内容时间) Hemasphere Q1 · IF 11.3(JCR 2025)

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中文摘要

在嵌合抗原受体(CAR)T细胞治疗研究中纳入患者报告结局(PRO)测量指标,对于从独特的患者视角理解这一新型治疗方法的影响至关重要。

我们进行了一项范围综述,以梳理2015年1月至2022年7月期间发表的、在血液系统恶性肿瘤患者的CAR-T 细胞治疗研究中使用PRO测量指标的相关文献。共纳入14项研究,其中7项(50%)为研究性早期试验,6项(42.9%)为观察性研究,1项(7.1%)为试点研究。EQ-5D和PROMIS-29是使用频率最高的2种PRO测量工具,分别纳入6项(42.9%)和5项(35.7%)研究。尽管研究设计存在差异,但似乎有证据表明,自CAR-T 细胞输注后,在身体功能和疲劳等重要领域存在随时间改善的趋势,至少在治疗有应答的患者中如此。

总体而言,本综述纳入的研究通过提供补充安全性和有效性知识的新信息,展示了PRO评估在CAR-T 细胞治疗研究中的附加价值。

然而,未来研究仍有若干问题有待解答。例如,关于患者在疾病轨迹重要阶段的体验,现有证据有限,仅有4项(28.6%)和5项(35.7%)研究分别提供了CAR-T 细胞输注后前2周和第一年后的PRO信息。在未来临床试验及接受CAR-T 细胞治疗患者的真实世界环境中,更系统地实施高质量PRO评估的时机已经成熟。

展开英文摘要原文

The inclusion of patient-reported outcome (PRO) measures in chimeric antigen receptor (CAR) T-cell therapy research is critical for understanding the impact of this novel approach from a unique patient standpoint.

We performed a scoping review to map the available literature on the use of PRO measures in CAR T-cell therapy studies of patients with hematologic malignancies published between January 2015 and July 2022. Fourteen studies were identified, of which 7 (50%) were investigational early-phase trials, 6 (42. 9%) were observational studies, and 1 (7. 1%) was a pilot study.

The EQ-5D and the PROMIS-29 were the 2 most frequently used PRO measures, being included in 6 (42. 9%) and 5 (35. 7%) studies, respectively. Despite differences in study designs, there seems to be evidence of improvements over time since CAR T-cell infusion in important domains such as physical functioning and fatigue, at least in patients who respond to therapy.

Overall, the studies identified in our review have shown the added value of PRO assessment in CAR T-cell therapy research by providing novel information that complements the knowledge on safety and efficacy.

However, there are several questions which remain to be answered in future research. For example, limited evidence exists regarding patient experience during important phases of the disease trajectory as only 4 (28. 6%) and 5 (35. 7%) studies provided information on PROs during the first 2 weeks from CAR T-cell infusion and after the first year, respectively. Time is ripe for a more systematic implementation of high-quality PRO assessment in future clinical trials and in real-life settings of patients treated with CAR T-cell therapy.

论文信息

作者
Efficace F、Cannella L、Sparano F、Giesinger JM、Vignetti M、Baron F、Bruera E、Luppi M
第一作者单位
Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.Italy
通讯作者单位
Department of Hematology and Cellular Therapy, Medical Clinic and Policlinic I, Leipzig University Hospital, Germany.Germany
文献类型
范围综述
期刊
HemaSphere2022 Dec
原文标识
PubMed 36504547 · DOI 10.1097/HS9.0000000000000802