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:A 24-month updated analysis of the comparative effectiveness of ZUMA-5 (axi-cel) vs. SCHOLAR-5 external control in relapsed/refractory follicular lymphoma.
A 24-month updated analysis of the comparative effectiveness of ZUMA-5 (axi-cel) vs. SCHOLAR-5 external control in relapsed/refractory follicular lymphoma.
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这项更新分析采用了比先前发表的分析更长的最短随访时间,显示与现有疗法相比,axi-cel 在 r/r FL 中改善的疗效具有持久性。
在ZUMA-5试验(临床试验标识:NCT03105336)中,axicabtagene ciloleucel(axi-cel;一种CAR-T 细胞疗法)在复发/难治性(r/r)滤泡性淋巴瘤(FL)患者中显示出高比例的持久缓解,并且相对于SCHOLAR-5外部对照队列具有明显的优越性。我们使用ZUMA-5的24个月数据更新了这一比较。
SCHOLAR-5队列由2014年7月后开始≥3线治疗且符合ZUMA-5入组标准的r/r FL患者组成。通过倾向性评分,使用标准化死亡率比(SMR)加权,在预设预后因素上平衡各组患者特征。采用加权logistic回归比较总缓解率。使用Cox回归评估至事件发生时间结局。
在SCHOLAR-5中,143例患者经SMR加权后的权重总和为85,而ZUMA-5中为86例患者。ZUMA-5和SCHOLAR-5的中位随访时间分别为29.4个月和25.4个月。总生存期和无进展生存期的风险比分别为0.52(95% CI:0.28-0.95)和0.28(95% CI:0.17-0.45),均支持axi-cel。
In the ZUMA-5 trial (Clinical trials identification: NCT03105336), axicabtagene ciloleucel (axi-cel; a chimeric antigen receptor T-cell therapy) demonstrated high rates of durable response in relapsed/refractory (r/r) follicular lymphoma (FL) patients and clear superiority relative to the SCHOLAR-5 external control cohort. We update this comparison using the ZUMA-5 24-month data. RESEARCH DESIGN AND METHODS: The SCHOLAR-5 cohort is comprised of r/r FL patients who initiated ≥3 rd line of therapy after July 2014 and meeting ZUMA-5 eligibility criteria. Groups were balanced for patient characteristics through propensity scoring on prespecified prognostic factors using standardized mortality ratio (SMR) weighting. The overall response rate was compared using a weighted logistic regression. Time-to-event outcomes were evaluated using a Cox regression.
For SCHOLAR-5, the sum of weights for the 143 patients was 85 after SMR weighting, versus 86 patients in ZUMA-5. The median follow-up was 29.4 months and 25.4 months for ZUMA-5 and SCHOLAR-5, respectively. The hazard ratios for overall survival and progression-free survival were 0.52 (95% confidence interval (CI): 0.28-0.95) and 0.28 (95% CI: 0.17-0.45), favoring axi-cel.
This updated analysis, using a longer minimum follow-up than a previously published analysis, shows that the improved efficacy of axi-cel, relative to available therapies, in r/r FL is durable. .
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