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 细胞疗法与自体干细胞移植治疗复发/难治性弥漫大 B 细胞淋巴瘤的疗效：系统综述
英文原题：Efficacy of chimeric antigen receptor T cell therapy and autologous stem cell transplant in relapsed or refractory diffuse large B-cell lymphoma: A systematic review.
查看英文原题
Efficacy of chimeric antigen receptor T cell therapy and autologous stem cell transplant in relapsed or refractory diffuse large B-cell lymphoma: A systematic review.
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研究概要
尽管 CAR-T 细胞治疗显示出有益的 ORR，但 auto-HSCT 在 R/R DLBCL 患者中表现出更好的长期治疗优势。不同亚组的生存结局一致。
研究思路结论见上方概要
背景
我们旨在比较CAR-T（CAR-T）细胞疗法与自体干细胞移植（auto-HSCT）在复发/难治性弥漫大B细胞淋巴瘤（R/R DLBCL）中的疗效。
方法
我们在PubMed、Cochrane Library、Springer和Scopus中检索了截至2022年1月31日的合格出版物。共纳入16篇出版物，涉及3484例患者，使用STATA SE软件独立评估和分析。
结果
接受CAR-T 细胞治疗的患者比接受auto-HSCT治疗的患者表现出更好的ORR和PR（CAR-T vs. auto-HSCT，ORR：80% vs. 73%，HR：0.90，95%CI：0.76-1.07，P = 0.001；PR：20% vs. 14%，HR：0.65，95%CI：0.62-0.68，P = 0.034）。6个月OS无显著差异（CAR-T vs. auto-HSCT，6个月OS：81% vs. 84%，HR：1.23，95%CI：0.63-2.38，P = 0.299），而auto-HSCT在1年和2年OS方面表现更优（CAR-T vs. auto-HSCT，1年OS：64% vs. 73%，HR：2.42，95%CI：2.27-2.79，P < 0.001；2年OS：54% vs. 68%，HR：1.81，95%CI：1.78-1.97，P < 0.001）。auto-HSCT在PFS方面也具有优势（CAR-T vs. auto-HSCT，6个月PFS：53% vs. 76%，HR：2.81，95%CI：2.53-3.11，P < 0.001；1年PFS：46% vs. 61%，HR：1.84，95%CI：1.72-1.97，P < 0.001；2年PFS：42% vs. 54%，HR：1.62，95%CI：1.53-1.71，P < 0.001）。按年龄、既往治疗线数和ECOG评分进行亚组分析，以比较两种治疗方式的疗效。
展开英文摘要原文
BACKGROUND
We aimed to compare the efficacy of chimeric antigen receptor T (CAR-T) cell therapy with that of autologous stem cell transplantation (auto-HSCT) in relapsed/refractory diffuse large B cell lymphoma (R/R DLBCL). RESEARCH DESIGN AND METHODS: We searched eligible publications up to January 31st, 2022, in PubMed, Cochrane Library, Springer, and Scopus. A total of 16 publications with 3484 patients were independently evaluated and analyzed using STATA SE software.
RESULTS
Patients who underwent CAR-T cell therapy showed a better overall response rate (ORR) and partial response (PR) than those treated with auto-HSCT (CAR-T vs. auto-HSCT, ORR: 80% vs. 73%, HR:0.90,95%CI:0.76-1.07, P = 0.001; PR: 20% vs. 14%, HR:0.65,95%CI:0.62-0.68, P = 0.034). No significant difference was observed in 6-month overall survival (OS) (CAR-T vs. auto-HSCT, six-month OS: 81% vs. 84%, HR:1.23,95%CI:0.63-2.38, P = 0.299), while auto-HSCT showed a favorable 1 and 2-year OS (CAR-T vs. auto-HSCT, one-year OS: 64% vs. 73%, HR:2.42,95%CI:2.27-2.79, P < 0.001; two-year OS: 54% vs. 68%, HR:1.81,95%CI:1.78-1.97, P < 0.001). Auto-HSCT also had advantages in progression-free survival (PFS) (CAR-T vs. auto-HSCT, six-month PFS: 53% vs. 76%, HR:2.81,95%CI:2.53-3.11, P < 0.001; one-year PFS: 46% vs. 61%, HR:1.84,95%CI:1.72-1.97, P < 0.001; two-year PFS: 42% vs. 54%, HR:1.62,95%CI:1.53-1.71, P < 0.001). Subgroup analysis by age, prior lines of therapy, and ECOG scores was performed to compare the efficacy of both treatment modalities.
CONCLUSION
Although CAR-T cell therapy showed a beneficial ORR, auto-HSCT exhibited a better long-term treatment superiority in R/R DLBCL patients. Survival outcomes were consistent across different subgroups.
论文信息
- 作者
- Tian L、Li C、Sun J、Zhai Y、Wang J、Liu S、Jiang Y、Wu W
- 单位
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.China
- 文献类型
- 系统综述 · 非美国政府资助研究
- 期刊
- Frontiers in immunology2022
- 原文标识
- PubMed 36733398 · DOI 10.3389/fimmu.2022.1041177
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