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
英文原题:Treatment Outcomes with Standard of Care in Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Real-World Data Analysis.
Treatment Outcomes with Standard of Care in Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Real-World Data Analysis.
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接受化疗、单药利妥昔单抗/奥妥珠单抗、单药来那度胺或这些药物联合治疗的 R/R DLBCL 患者,其结局仍然不佳,尤其是对于治疗具有挑战性的 R/R DLBCL 患者。这些发现凸显了对新型、安全且有效疗法的未满足需求,特别是对于治疗具有挑战性的 R/R DLBCL 人群。
尽管针对复发/难治性(R/R)弥漫性大B细胞淋巴瘤(DLBCL)出现了新的疗法,但化疗、单药利妥昔单抗/奥妥珠单抗、单药来那度胺或这些药物的联合方案仍被普遍使用。
这项回顾性研究利用4226份真实世界电子健康记录中的纵向数据,描述R/R DLBCL患者的结局。符合条件的患者在2010年1月至2022年3月期间被诊断为DLBCL,并患有R/R疾病,接受过1线既往系统性治疗(LOT),其中包括1种含抗CD20的方案。
共纳入573例接受过1线既往治疗的患者(分别有31.2%和13.4%接受过2线和3线既往治疗)。中位随访时间为7.7个月。大多数患者(57.1%)为男性;平均标准差(SD)年龄为63(14.7)岁。总缓解率和完全缓解率(95%置信区间(CI))分别为52%(48-56)和23%(19-27)。中位缓解持续时间和完全缓解持续时间分别为3.5和18.4个月。中位无进展生存期和总生存期(95% CI)分别为3.0(2.8-3.3)和12.9(10.1-16.9)个月。与不具有这些特征的患者相比,既往LOT数量较多、原发性难治、对末线LOT难治、对末线含抗CD20方案难治以及既往暴露于CAR-T 的患者结局更差(即难以治疗的R/R DLBCL)。
This retrospective study utilized longitudinal data from 4226 real-world electronic health records to characterize outcomes in patients with R/R DLBCL. Eligible patients were diagnosed with DLBCL between January 2010 and March 2022 and had R/R disease treated with 1 prior systemic line of therapy (LOT), including 1 anti-CD20-containing regimen.
A total of 573 patients treated with 1 prior LOT were included (31.2% and 13.4% with 2 and 3 prior LOTs, respectively). Median duration of follow-up was 7.7 months. Most patients (57.1%) were male; mean standard deviation (SD) age was 63 (14.7) years. Overall and complete response rates (95% confidence interval (CI) were 52% (48-56) and 23% (19-27). Median duration of response and duration of complete response were 3.5 and 18.4 months. Median progression-free and overall survival (95% CI) was 3.0 (2.8-3.3) and 12.9 (10.1-16.9) months, respectively. Patients with a higher number of prior LOTs, primary refractoriness, refractoriness to last LOT, refractoriness to last anti-CD20-containing regimen, and prior CAR T exposure had worse outcomes (i.e., challenging-to-treat R/R DLBCL) compared with those without these characteristics.
Outcomes in patients with R/R DLBCL treated with chemotherapy, single-agent rituximab/obinutuzumab, single-agent lenalidomide, or combinations of these agents remain poor, especially for those with challenging-to-treat R/R DLBCL. These findings underscore the unmet need for new, safe, and effective therapies, especially for challenging-to-treat R/R DLBCL populations.
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